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Supraclavicular brachial plexus block with 0.75 % ropivaciane and with additives tramadol, fentanyl- a comparative pilot study.

Authors:Ravi Madhusudhana*, Krishna Kumar , Ramesh Kumar , Somasekharam Potli, Dinesh Karthik, Manu Kapil.
Int J Biol Med Res. 2011; 2(4): 1061 – 1063  |  PDF File

Abstract

BACKGROUND Ropivacaine is a long acting regional anaesthetic that is structurally related to Bupivacaine but less toxic than bupivacaine. The efficacy of ropivacaine may be altered with co administration of opiod additives like Tramadol, Fentanyl in terms of duration of postoperative analgesia. OBJECTIVES To determine and compare efficacy of supraclavicular block of brachial plexus with ropivacaine, ropivacaine and tramadol, ropivacaine and fentanyl in terms of onset, quality and duration of sensory and motor block for patients undergoing surgery for the upper limb. METHODOLOGY: After Informed consent, with standard precautions to avoid complications, total of 30 patients ,10 for each group, age group ranging between 18 to 60years, ASA 1&2 category posted for upper limb surgery were selected. Group 1 received inj Ropivacaine 0.75% 30ml, Group 2 received inj Ropivacaine 0.75% 29 ml with inj Tramadol 50 mg(1 ml), and Group 3 received inj Ropivacaine 0.75% 29 ml with inj Fentanyl 50 mcg(1 ml). The Exclusion Criteria was history of any hypersensitivity to ropivacaine, hemodynamic instability, arrhythmias on treatment, local infection/inflammation and Patient refusal Blinding and randomization done.The onset, quality and duration of Sensory and Motor block with plain ropivacaine, and with additives Fentanyl, Tramadol was compared. The data collected statistically analyzed. Results: There was a significant difference between group 1 and 3 for duration of sensory & motor block, VAS score at the p = 0.0001 . Also there was a significant difference between group 2 and 3 for duration of sensory & motor block at p=0.0001 and VAS score at the p value of 0.001 . Conclusion: The addition of opiods to local anaesthetics in our study showed that there is significant beneficial effects on duration of sensory , motor blockade and VAS scores compared to plain ropivacaine alone.