title: Does the addition of tramadol and ketamine to ropivacaine prolong the axillary brachial plexus block?
abstract: OBJECTIVE
  A prospective, randomized, controlled, double-blind clinical trial to assess the effect of tramadol and ketamine, 50 mg, added to ropivacaine in brachial plexus anesthesia.
  
  
  METHODS
  Thirty-six ASA physical statuses I and II patients, between 18 and 60 years of age, scheduled for forearm and hand surgery under axillary brachial plexus block, were allocated to 3 groups. Group R received 0.375% ropivacaine in 40 mL, group RT received 0.375% ropivacaine in 40 mL with 50 mg tramadol, and group RK received 0.375% ropivacaine in 40 mL with 50 mg ketamine for axillary brachial plexus block. The onset times and the duration of sensory and motor blocks, duration of analgesia, hemodynamic parameters, and adverse events (nausea, vomiting, and feeling uncomfortable) were recorded.
  
  
  RESULTS
  The onset time of sensorial block was the fastest in ropivacaine + tramadol group. Duration of sensorial and motor block was the shortest in the ropivacaine + tramadol group. Duration of analgesia was significantly longer in ropivacaine + tramadol group.
  
  
  CONCLUSIONS
  We conclude that when added to brachial plexus analgesia at a dose of 50 mg, tramadol extends the onset and duration time of the block and improves the quality of postoperative analgesia without any side effects.
authors.affiliation: Department of Anesthesiology, Medical Faculty of Karadeniz Technical University, 61080 Trabzon, Turkey.
authors.forename: Ahmet Can
authors.initials: AC
authors.lastname: Senel
authors.affiliation: Department of Anesthesiology, Medical Faculty of Karadeniz Technical University, 61080 Trabzon, Turkey.
authors.forename: Ozlem
authors.initials: O
authors.lastname: Ukinc
authors.affiliation: Department of Orthopedics, Medical Faculty of Karadeniz Technical University, 61080 Trabzon, Turkey.
authors.forename: Alper
authors.initials: A
authors.lastname: Timurkaynak
mesh_terms: D000328:Adult; D000577:Amides / Q000008:administration & dosage; D000701:Analgesics, Opioid / Q000008:administration & dosage; D000758:Anesthesia / Q000379:methods*; D001917:Brachial Plexus / Q000187:drug effects; D065527:Brachial Plexus Block / Q000379:methods*; D004311:Double-Blind Method; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D006801:Humans; D007649:Ketamine / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D000077212:Ropivacaine; D013710:Tendons / Q000473:pathology / Q000601:surgery; D014147:Tramadol / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D000577:Amides; D000701:Analgesics, Opioid; D014147:Tramadol; D007649:Ketamine; D000077212:Ropivacaine