Does the addition of Tramadol to local anaesthetic mixture improve the quality of axillary brachial plexus block: A comparative study at the teaching hospital,Dera Ghazi Khan

Background:in peripheral nerve blocks,adjuvants are added to local anaesthetics to improve the quality of anaesthesiaand analgesia. this study was conducted to evaluate the efficacy of tramadol when combined with bupivacaine in axillary brachial plexus block for upper limb surgery. method: in this prospective randomized control trial,two groups of 30 patients each were investigated. group i was administered 32ml of tramadol-local anaesthetic mixture[20ml 0.5% bupivacaine + 10ml xylocaine with 1:200,000 adrenaline + 2ml tramadol (100mg)] and group ii was given saline-local anaesthetic mixture [20ml 0.5% bupivacaine + 10ml xylocaine with 1:200,000 adrenaline + 2ml saline]. the onset of sensory and motor block,duration of sensory and motor block and time of first request for analgesia postoperatively were assessed. results:the onset of motor and sensory block was faster in tramadol-bupivacaine mixture than bupivacaine alone and difference was significant (p=0.001) (p=0.01). in group i,significantly prolonged duration of motor and sensory block was seen.(p=0.000). in comparison to group ii,prolonged time of first request for rescue analgesia was seen in group i(p=0.04). in group i,5 patients (16%) did not require analgesia postoperatively. only one patient complained of nausea in group i. conclusion: the study suggests that tramadol when added to local anaesthetic enhances the quality of anaesthesia and analgesia.