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Comparison of Buprenorphine and Tramadol as an Adjuvant to Bupivacaine in Supraclavicular Brachial Plexus Block

Amol Singam, Associate Professor, Dept. of Anaesthesia, Jawaharlal Nehru Medical College, Sawangi (Meghe), Wardha, Maharashtra 442001, India. , Manisha Taware1 , Amol Singam2 , Ashok Chaudhari3

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Indian Journal of Anesthesia and Analgesia 5(1):p 22-27, January-February 2018. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.5118.4

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Abstract

Background: Supraclavicular brachial plexus block is a good alternative to general anaesthesia for upper limb surgery below shoulder as it avoids the untoward effects of general anaesthesia. Block when given only with local anaesthetic can’t prolong postoperative analgesia. Presence of opioid receptors in the peripheral nervous system allows us to use various opioids as an adjuvant to achieve prolong postoperative analgesia. This study was done to compare tramadol and buprenorphine as an adjuvant to 0.35% bupivacaine in supraclavicular brachial plexus block in terms of efficacy and safety. Methods: A prospective, randomized study was done in 80 patients of American Society of Anaesthesiologist (ASA) class I and II undergoing elective upper limb orthopedic surgeries under supraclavicular block. Patients were randomized into two groups of 40 each. Group BPatients received inj. bupivacine 0.35%, 2mg/kg + inj. buprenorphine 6g/kg. while in group T- Patients received inj. bupivacine 0.35% 2mg/kg+ inj. tramadol 2 mg/kg. Onset and duration of sensory and motor block, duration of postoperative analgesia and adverse effects of study drugs were compared in both the groups. Results: Sensory and motor block onset times were shorter in group B than in group T (p < 0.05). Motor block duration was longer in group B than in group T (p < 0.05).Similarly, duration of analgesia was longer in group B compared to group T (942.83±124.51 min vs 478.31±52.60 min) (p<0.001). Conclusion: Buprenorphine when added to bupivacaine in supraclavicular block shortened the onset of sensory and motor block, enhances the duration of motor block and duration of analgesia compared to tramadol without significant side effects.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.5118.4

Keywords

Buprenorphine; Tramadol; Supraclavicular Block. 

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