Comparative study of systemically and perineurally administered tramadol as an adjunct for supraclavicular brachial plexus block

Nagpal, Vishal; Rana, Shelly; Singh, J. J.; Chaudhary, Sudarshan Kumar

doi:10.4103/0970-9185.155147

Cited by 13 publications

(7 citation statements)

References 11 publications

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“…[ 1 ] Since the duration of postoperative analgesia is often a limiting factor, many adjuvants, such as tramadol, morphine, fentanyl, epinephrine, α 2 agonists, dexamethasone, neostigmine, midazolam, ketamine, and sodium bicarbonate, have been used along with local anesthetics to this end. [ 2 3 4 5 ] These are often associated with adverse effects, and the results have been inconclusive. [ 6 ]…”

Section: Introductionmentioning

confidence: 99%

Comparison of magnesium sulfate and ketamine with ropivacaine in supraclavicular brachial plexus block: A randomized controlled trial

et al. 2020

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Background: Supraclavicular brachial plexus block offers good operating conditions with limited postoperative analgesia. Magnesium sulfate (MgSO 4 ) and ketamine block peripheral nociception mediated via N-methyl-D-aspartate receptors. Aims: The aim of this study was to evaluate the effect of MgSO 4 and ketamine on the duration of analgesia in brachial block. Settings and Design: This was a prospective, randomized, controlled double-blind study. Materials and Methods: One hundred and five adult patients were randomly divided into three groups: Group I = 27 mL of 0.5% ropivacaine; Group II = 27 mL of 0.5% ropivacaine + 250 mg MgSO 4 ; and Group II = 27 mL of 0.5% ropivacaine + 2 mg.kg −1 ketamine. Normal saline was added to make a total volume of 30 mL. The onset and duration of the sensorimotor blockade, quality and duration of postoperative analgesia, and adverse effects were assessed. Statistical Analysis: Statistical analysis was performed using SPSS, version 17.0 software (SPSS, Inc., Chicago, IL, USA). Chi-square test was used for nonparametric and ANOVA for parametric data. Post hoc Student's paired t -test was applied wherever indicated. The results were expressed as mean and standard deviation or numbers (%). P < 0.05 was considered as statistically significant. Results: The duration of analgesia was significantly longer in Group II (8.78 ± 0.97 h) compared to Group I (6.76 ± 0.92 h; P < 0.001) and Group III (7.1 ± 0.89 h; P < 0.001). Intervention groups had lower postoperative visual analog scores at 8, 12, and 24 h compared to the control group. Sedation, nystagmus, and hallucinations were observed in Group III. Conclusion: The addition of MgSO 4 to ropivacaine in supraclavicular brachial plexus block significantly prolongs the duration of analgesia. MgSO 4 improves the quality of postoperative analgesia with lesser incidence of side effects when compared to ketamine.

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Section: Introductionmentioning

confidence: 99%

Comparison of magnesium sulfate and ketamine with ropivacaine in supraclavicular brachial plexus block: A randomized controlled trial

et al. 2020

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“…In a double-blind randomized clinical study, Nagpal et al [12] reported that 100 mg of tramadol injected perineurally along with 0.5% bupivacaine solution for supraclavicular brachial plexus block resulted in a faster onset of both sensory and motor blocks, prolonged duration of the motor block, and delayed demands for rescue analgesia compared to bupivacaine alone or to bupivacaine plus tramadol intravenous injection [12]. Another randomized controlled study with patients scheduled for carpal tunnel release performed under axillary brachial plexus block [13] reported that the addition of 100 mg tramadol to the 0.75% ropivacaine solution enhanced the onset of the nerve block compared to the control group, and prolonged anesthesia and analgesia similarly to that obtained with clonidine or sufentanil as adjuvants but with fewer side effects [13].…”

Section: Discussionmentioning

confidence: 99%

Addition of 100 mg of Tramadol to 40 mL of 0.5% Ropivacaine for Interscalene Brachial Plexus Block Improves Postoperative Analgesia in Patients Undergoing Shoulder Surgeries as Compared to Ropivacaine Alone—A Randomized Controlled Study

et al. 2019

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Background and objectives: Brachial plexus block is commonly used in shoulder surgery, as it provides satisfactory surgical conditions and adequate postoperative pain control. However, there are contradictory reports regarding the addition of tramadol to the injected regional anesthetic solution. We performed a prospective randomized study to evaluate the effectiveness of tramadol as an adjuvant to ropivacaine during interscalene brachial plexus block and assess its impact on the opioid consumption and the early postoperative pain in patients that underwent shoulder surgery. Materials and Methods: Eighty patients scheduled for elective shoulder surgery and anesthesia via interscalene brachial plexus block were randomly divided into two groups. In group A (n = 40), a solution of 40 mL of ropivacaine 0.5% and 2 mL (100 mg) of tramadol was administered during the brachial plexus block, while in group B (n = 40), a solution of 40 mL of ropivacaine 0.5% and 2 mL NaCl 0.9% (placebo) was administered. The effectiveness and duration of sensory and motor blocks were recorded in both groups. The sensory block was assessed recording the loss of sensation to pin prick test over the skin distribution of the axillary, radial, and musculocutaneous nerves. The motor block was assessed using the modified 3-point Bromage score (0–2 points). Cumulative morphine consumption and pain, using the Visual Analog Scale (VAS), were evaluated in both groups at 2, 4, 8, and 24 h after surgery. Results: Sensory block onset was achieved earlier in group A than in group B (5.21 ± 3.15 minutes (min) vs. 7.1 ± 4.51 min, p = 0.029). The motor block onset was similar between the two groups (13.08 ± 6.23 min vs. 13.28 ± 6.59 min; p = 0.932). The duration of the sensory block was longer in group A as compared to group B (13 ± 2.3 h vs. 12 ± 2.8 h; p = 0.013). The duration of the motor block did not present any difference between the groups (10 ± 2.2 h vs. 10 ± 2.8 h; p = 0.308). Differences in morphine administration were not significant at 2, 4, and 8 h, however, morphine consumption was found to be decreased in group A 24 h postoperatively A (p = 0.04). The values of VAS were similar at 2, 4, and 8 h, however, they were lower in group A at 24 h (p < 0.013). Conclusions: Combined regional administration of tramadol and ropivacaine during interscalene brachial plexus block improves the time of onset and the duration of the sensory block, while it is associated with reduced morphine consumption during the first 24 h after shoulder surgery.

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“…In a supraclavicular brachial plexus block, 100 mg tramadol with bupivacaine was evaluated to have reduced the onset time of motor and sensory block and enhanced the duration of sensory block, motor block, and postoperative analgesia. [ 22 , 23 ] Tramadol has also been used as an adjunct with ropivacaine and levobupivacaine in a brachial plexus block. The study results demonstrated that tramadol significantly reduced the onset time of the brachial plexus block and prolonged the duration of anesthesia and postoperative analgesia.…”

Section: Discussionmentioning

confidence: 99%

Adding Tramadol Prolonged Analgesic Efficassy Of Articaine At Axillary Brachial Plexus Block

Kılınç¹

2018

Sisli Etfal

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Objectives: Articaine is a rapid-onset, short-duration, local anesthetic. The aim of this study was to study the effect of adding tramadol to articaine in an axillary block to prolong the analgesic effect. Methods: This study was conducted with 60 patients of American Association of Anesthesiologists classification I or II and aged 18 to 60 years who underwent hand or forearm surgery with an axillary plexus block using a nerve stimulation technique. The patients were randomized into 2 groups: Group A (n=30) received 40 mL 1% articaine and Group AT (n=30) was administered 40 mL 1% articaine with 100 mg tramadol. The onset of sensory block, motor block, duration of sensorial block and motor block, duration of analgesia and hemodynamic parameters were recorded before the block and 5, 10, 20, 30, 60, 120, 180 minutes after the local anesthetic injection. Results: The sensory block duration in Group AT (187.5±13.0 min) was significantly longer than that of group A (140.78±8.74 min) (p<0.02). The motor block duration in Group AT (137.4±3 min) was significantly longer than that seen in Group A (93.71±9.6 min) (p<0.01). The duration of analgesia was longer in Group AT (218.8±18.2 min) than in Group A (170.8±17.2 min) (p<0.05). In group AT, 2 patients experienced the side effect of nausea and 1 patient had hypotension in the postoperative period. Conclusion: This study demonstrated that the addition of 100 mg of tramadol to articaine used for an axillary plexus block prolonged analgesia.

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Comparative study of systemically and perineurally administered tramadol as an adjunct for supraclavicular brachial plexus block

Cited by 13 publications

References 11 publications

Comparison of magnesium sulfate and ketamine with ropivacaine in supraclavicular brachial plexus block: A randomized controlled trial

Comparison of magnesium sulfate and ketamine with ropivacaine in supraclavicular brachial plexus block: A randomized controlled trial

Addition of 100 mg of Tramadol to 40 mL of 0.5% Ropivacaine for Interscalene Brachial Plexus Block Improves Postoperative Analgesia in Patients Undergoing Shoulder Surgeries as Compared to Ropivacaine Alone—A Randomized Controlled Study

Adding Tramadol Prolonged Analgesic Efficassy Of Articaine At Axillary Brachial Plexus Block

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