Tramadol and Dexamethasone as Adjuvant to Bupivacaine in Supraclavicular Brachial Plexus Block
DOI:
https://doi.org/10.22219/sm.Vol20.SMUMM1.33082Abstract
Background: To assess the effects of combining Tramadol and Dexamethasone with Bupivacaine in supraclavicular brachial plexus block for upper limb surgeries.
Material and Methods: A clinical research was performed with sixty patients who received upper limb surgery with a supraclavicular brachial plexus block. The study encompassed a total of 60 patients who were divided into two groups, with 30 patients in each group. Group D was administered a blend of Bupivacaine and Dexamethasone, whilst Group T was given a mixture of Bupivacaine and Tramadol, resulting in a combined amount of 25 ml. The study recorded the beginning and length of the sensory and motor block. We meticulously observed the hemodynamic variables throughout the research, until the administration of the first rescue analgesic.
Results: In group D, the mean time for motor block to occur was 5.10±0.92 minutes, whereas in group T, it took 7.93±0.98 minutes. Group D had an average sensory block onset time of 8.23±1.22 minutes, whereas Group T had a slightly longer average onset time of 10.97±1.22 minutes. Group D had an average motor block duration of 560.53±24.46 minutes, whereas group T had a duration of 358.93±20.85 minutes. Group D had a mean duration of sensory block of 745.17±32.81 minutes, whereas group T had a slightly shorter duration of 457.07±16.36 minutes. In group D, the average time for the first rescue analgesia was 961.50±32.94 minutes, whereas in group T, it was 524.17±16.46 minutes.
Conclusion: Inclusion of Dexamethasone led to a noticeably quicker onset of motor and sensory block in comparison to Tramadol. In a recent study, researchers discovered that when Dexamethasone was added to the mix, it had a notable impact on the duration of both motor and sensory block. The effects were significant and promising. When Dexamethasone was added, it noticeably increased the duration until the first rescue analgesia, in comparison to Tramadol.
Downloads
References
Alarasan, a. K., agrawal, j., choudhary, b., melhotra, a., uike, s. & mukherji, a. 2016. Effect of dexamethasone in low volume supraclavicular brachial plexus block: a double-blinded randomized clinical study. Journal of anaesthesiology clinical pharmacology, 32, 234-239.
Arish, b., babu, d. D., lazarus, s. P., chandar, d. D., balasubramanian, s. & kumar, k. S. 2016. Effect of dexamethasone as an adjuvant to local anesthetic in supraclavicular brachial plexus block. Int j sci stud, 3, 147-53.
Brummett, c. M. & williams, b. A. 2011. Additives to local anesthetics for peripheral nerve blockade. International anesthesiology clinics, 49, 104-116.
Chennai, t. N. 2013. A study of the efficacy of tramadol as an adjuvant to bupivacaine in brachial plexus block.
Choi, s., rodseth, r. & mccartney, c. 2014. Effects of dexamethasone as a local anaesthetic adjuvant for brachial plexus block: a systematic review and meta-analysis of randomized trials. British journal of anaesthesia, 112, 427-439.
D'souza, r. S. & johnson, r. L. 2023. Supraclavicular block. Statpearls [internet]. Statpearls publishing.
Deshpande, j. P., ghodki, p. S. & sardesai, s. P. 2017. The analgesic efficacy of dexamethasone added to ropivacaine in transversus abdominis plane block for transabdominal hysterectomy under subarachnoid block. Anesthesia essays and researches, 11, 499-502.
Estebe, j.-p., le corre, p., clement, r., du plessis, l., chevanne, f., le verge, r. & ecoffey, c. 2003. Effect of dexamethasone on motor brachial plexus block with bupivacaine and with bupivacaine-loaded microspheres in a sheep model. European journal of anaesthesiology, 20, 305-310.
Lanz, e., theiss, d. & jankovic, d. 1983. The extent of blockade following various techniques of brachial plexus block. Anesthesia & analgesia, 62, 55-58.
Marhofer, p., greher, m. & kapral, s. 2005. Ultrasound guidance in regional anaesthesia. British journal of anaesthesia, 94, 7-17.
Nagpal, v., rana, s., singh, j. & chaudhary, s. K. 2015. Comparative study of systemically and perineurally administered tramadol as an adjunct for supraclavicular brachial plexus block. Journal of anaesthesiology clinical pharmacology, 31, 191-195.
Persec, j., persec, z., kopljar, m., zupcic, m., sakic, l., zrinjscak, i. K. & marinic, d. K. 2014. Low-dose dexamethasone with levobupivacaine improves analgesia after supraclavicular brachial plexus blockade. International orthopaedics, 38, 101-105.
Raj, s. A., singh, d. R., charles, s. A. J. & krishnaveni, n. 2017. Efficacy of tramadol or dexamethasone as an adjuvant to levobupivacaine in ultrasound-guided supraclavicular plexus block for upper limb surgery: a randomized double-blinded controlled study. Anesthesia essays and researches, 11, 567-571.
Regmi, n. K., subba, s. & sharma, u. C. 2015. A comparative clinical evaluation of efficacy of tramadol as an adjuvant to bupivacaine en brachial plexus block for upper limb surgery. Journal of nepalgunj medical college, 13, 13-16.
Rios, j. J. P., bernáldez, g. I. L., oropeza, e. O., aguilar, o. J. M. & olvera, m. D. 2023. Closed reduction of fracture-dislocation of the sub-axial cervical spine with gardner-wells tongs. Technical note. Trauma case reports, 48, 100948.
Seger, c. & cannesson, m. 2020. Recent advances in the technology of anesthesia. F1000research, 9.
Shah, s., shah, b. & deb, c. 2016. Comparison of tramadol and dexamethasone as an adjuvant to bupivacaine in supraclavicular brachial plexus block: a randomised comparative study in patients undergoing elective upper limb surgeries. Int j intg med sci, 3, 321-26.
Shaikh, s. I. & veena, k. 2019. Midazolam as an adjuvant in supraclavicular brachial plexus block. Anaesthesia, pain & intensive care, 7-12.
Shrestha, b., maharjan, s., shrestha, s., gautam, b., thapa, c., thapa, p. & joshi, m. 2007. Comparative study between tramadol and dexamethasone as an admixture to bupivacaine in supraclavicular brachial plexus block. Jnma j nepal med assoc, 46, 158-64.
Solanki, r., kishnani, p. & desai, j. 2019. Comparison of tramadol & dexamethasone as adjuvants to local anaesthetic in supraclavicular brachial plexus block. Indian journal of anesthesia and analgesia, 627.
Taggarsi, d. A. 2016. Comparison of 4 mg dexamethasone versus 8 mg dexamethasone as an adjuvant to bupivacaine in supraclavicular brachial plexus blockade. Rajiv gandhi university of health sciences (india).
Talukdar, m., begum, h., shoman, m., khatun, u. & talukdar, m. 2013. Anaesthetic and analgesic effects of adding dexamethasone to bupivacaine in supraclavicular brachial plexus block–a comparative study. Journal of bangladesh college of physicians and surgeons, 31.
Vengadessane, a., rajaraman, j., raghuraman, m., prabu, r., damodaran, s. & sabu, b. 2020. Comparison of duration of analgesic effect of nalbuphine and morphine as an adjuvant to bupivacaine in the supraclavicular block under ultrasound guidance. Anesthesia: essays & researches, 14.
Vloka, j. D., smeets, a.-s., tsai, t. & bouts, c. 2020. Cervical plexus block–landmarks and nerve stimulator technique.
Wiles, m. & nathanson, m. 2010. Local anaesthetics and adjuvants–future developments. Anaesthesia, 65, 22-37.
Downloads
Published
Issue
Section
License
Copyright (c) 2024 Shrutika Ved, Neel Rana, Shruti Shah, Ruchi Shah, Ishitaben Gajipara, Mrugakshi Dave, Pratik Akhani
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution-ShareAlike 4.0 International License that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
