title: Comparative study of systemically and perineurally administered tramadol as an adjunct for supraclavicular brachial plexus block.
abstract: OBJECTIVE
  The study was designed to compare the effects of tramadol administered as an adjunct to bupivacaine in supraclavicular block to that of systemic administration, on postoperative analgesia and rescue analgesic requirement following upper limb surgeries.
  
  
  METHODS
  A prospective, randomized, controlled, double-blind study was undertaken in patients scheduled for upper limb surgeries under supraclavicular block. All the three group patients received either of the following drugs mixtures: Group A - bupivacaine 0.5%-18 ml + normal saline-7 ml for block and normal saline-10 ml intravenously. Group B - bupivacaine 0.5%-18 ml + normal saline-7 ml mixture for block and tramadol (100 mg) diluted to 10 ml - intravenously. Group C - bupivacaine 0.5%-18 ml + tramadol (100 mg) + normal saline-5 ml mixture and normal saline 10 ml intravenously. The patients were observed for sensory, motor onset along with the duration of sensory and motor block. Patients were monitored for sedation and hemodynamic parameters during intra-operative and postoperative period. Pain-free period and demand for rescue analgesia was noted in all the patients.
  
  
  RESULTS
  The study demonstrates that the mixture of tramadol and bupivacaine injected perineurally for supraclavicular brachial plexus block hastens the onset of sensory block, motor block and provides a longer duration of motor blockade and demand for rescue analgesia as compared to other two groups.
  
  
  CONCLUSIONS
  In conclusion, the addition of tramadol to bupivacaine mixtures as an adjunct for supraclavicular brachial plexus block provide better postoperative analgesia for orthopedic upper extremity surgery in comparison to control or systemic tramadol group without any side effects.
authors.affiliation: Department of Anaesthesia, Dr. R.P.G.M.C, Kangra, Himachal Pradesh, India.
authors.forename: Vishal
authors.initials: V
authors.lastname: Nagpal
authors.affiliation: Department of Anaesthesia, Dr. R.P.G.M.C, Kangra, Himachal Pradesh, India.
authors.forename: Shelly
authors.initials: S
authors.lastname: Rana
authors.affiliation: Department of Anaesthesia, Dr. R.P.G.M.C, Kangra, Himachal Pradesh, India.
authors.forename: Jai
authors.initials: J
authors.lastname: Singh
authors.affiliation: Department of Anaesthesia, Dr. R.P.G.M.C, Kangra, Himachal Pradesh, India.
authors.forename: Sudarshan Kumar
authors.initials: SK
authors.lastname: Chaudhary
keywords: Bupivacaine; supraclavicular brachial plexus; tramadol