title: Tramadol and 0.5% levobupivacaine for single-shot interscalene block: effects on postoperative analgesia in patients undergoing shoulder arthroplasty.
abstract: BACKGROUND
  The aim of this study was to evaluate the efficacy of tramadol as an adjuvant to the local anaesthetic solution in patients undergoing shoulder arthroscopy for rotator cuff tear after middle interscalene block (MIB).
  
  
  METHODS
  We enrolled 120 patients (ASA I-II), scheduled for arthroscopic surgery for rotator cuff tear. The patients were sedated with midazolam 0.02 mg/kg and haloperidol 2 mg i.v. before performing MIB. All subjects underwent a MIB with 0.4 mL/kg of 0.5% levobupivacaine. After computerized randomization, all patients were allocated in 1 of 3 groups, each including 40 subjects. Group Placebo (Group P) received 0.4 mL/kg of 0.5% levobupivacaine plus isotonic sodium chloride for MIB and isotonic sodium chloride i.m. Group "Perineural Tramadol" (Group TPN) received 0.4 ml/Kg of 0.5% levobupivacaine plus 1.5 mg/kg of tramadol perineurally and isotonic sodium chloride i.m. Group "Intramuscular Tramadol" (Group TIM) received 0.4 ml/Kg of 0.5% levobupivacaine plus isotonic sodium chloride perineurally and 1.5 mg/kg of tramadol i.m.
  
  
  RESULTS
  The MIB onset times were not statistically different in the three groups. The duration of analgesia was significantly longer in Groups TPN and TIM, where tramadol was administered, either i.m. or perineurally, compared with the placebo group. A significant statistical difference was found in the duration of analgesia between the group TPN and TIM.
  
  
  CONCLUSIONS
  The addition of tramadol to the local anaesthetic solution administered for MIB provided a longer duration of analgesia compared with placebo and i.m tramadol administration in patients undergoing arthroscopic surgery for rotator cuff tear.
authors.affiliation: Department of Anesthesia and Pain Therapy, Ospedale San Camillo, Brescia, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Alemanno
authors.forename: D
authors.initials: D
authors.lastname: Ghisi
authors.forename: A
authors.initials: A
authors.lastname: Fanelli
authors.forename: A
authors.initials: A
authors.lastname: Faliva
authors.forename: B
authors.initials: B
authors.lastname: Pergolotti
authors.forename: F
authors.initials: F
authors.lastname: Bizzarri
authors.forename: G
authors.initials: G
authors.lastname: Fanelli
mesh_terms: D000759:Adjuvants, Anesthesia / Q000008:administration & dosage*; D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D001178:Arthroplasty; D002045:Bupivacaine / Q000008:administration & dosage / Q000031:analogs & derivatives; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D007273:Injections, Intramuscular; D007552:Isotonic Solutions / Q000008:administration & dosage; D000077554:Levobupivacaine; D008297:Male; D008875:Middle Aged; D009407:Nerve Block; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D011446:Prospective Studies; D017006:Rotator Cuff / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D012965:Sodium Chloride / Q000008:administration & dosage; D013997:Time Factors; D014147:Tramadol / Q000008:administration & dosage*
chemical_list: D000759:Adjuvants, Anesthesia; D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D006993:Hypnotics and Sedatives; D007552:Isotonic Solutions; D014147:Tramadol; D012965:Sodium Chloride; D000077554:Levobupivacaine; D002045:Bupivacaine