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Indian Journal of Anesthesia and Analgesia

Volume  7, Issue 2, Mar-Apr 2020, Pages 601-605
 

Original Article

Effects of Adding Tramadol and Nalbuphine with Ropivacaine among Patients Undergoing Upper Limb Orthopedic Surgeries in A Tertiary Care Hospital

P Manohar, G Uma

1Associate Professor, 2Assistant Professor, Department of Anaesthesia, Karpaga Vinayaga Institute of Medical Sciences and Research Center, Maduranthakam, Tamil Nadu 603308, India.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.7220.23

Abstract

 

Background: Brachial plexus block is the widely-used nerve block in anesthesia for upperlimb surgeries. Ropivacaine, a newer local anesthetic with less cardiotoxicity used frequently now-a-days. Adding adjuvants increases the quality of the block and duration of analgesia. Aims of the study: Aim of the study is to compare the effects of adding 100 mg Tramadol and 10 mg Nalbuphine to 0.5% Ropivacaine in Supraclavicular brachial plexus block in patients undergoing upperlimb orthopedic surgeries. Also, study the block characteristics and complications during the study. Materials and Methods: A prospective randomized control study was conducted on, 60 ASA I/II patients of either sex at 20–50 years of age, undergoing upperlimb orthopedic
surgeries. Group RT received 32 ml of drug mixture (30 ml 0.5% Ropivacaine plus 2 ml of Tramadol), whereas Group RN received 32 ml of the mixture (30 ml of 0.5% Ropivacaine plus 10 mg of Nalbuphine). Time of onset and duration of sensory and motor blocks, duration of analgesia, time for first rescue analgesia and a total number of doses of rescue analgesia were monitored and recorded. Results: Onset of sensory block, motor block in Group RT (8.82 ± 2.2 and 9.45 ± 0.5) was statistically faster than Group RN (11.45 ± 2.1 and 12.23 ± 1.2)
respectively. The total duration of sensory and motor block was significantly more in Group RN than Group RT. The time of first rescue analgesia was significantly longer in Group RN (18.12 ± 1.2) than RT (14.32 ± 3.3). The total dose of rescue analgesia was statistically insignificant among the groups (2 vs 2). 5 patients in Group RT developed nausea and vomiting. Conclusion: The addition of Tramadol fastens the onset of sensory and motor blocks but the addition of Nalbuphine produces a longer duration of sensory and motor blocks with negligible complications.


Keywords : Ropivacaine; Tramadol; Nalbuphine; Brachial Plexus Block.
Corresponding Author : G Uma