Evaluation of efficacy of Tramadol as an adjuvant to Lignocaine in Intravenous Regional Anaesthesia for upper limb surgeries

Introduction- Intravenous Regional Anaesthesia (IVRA) is a type of regional anaethesia in which the limb is isolated from the systemic circulation by means of tourniquet. IVRA is particularly advantageous to use in critically ill patients having undercurrent systemic disease, associated head and neck injury, patient that are not fit for general anaesthesia and also in patients with full stomach requiring emergency surgery. It provides adequate intraoprerative analgesia and muscle relaxation. Recently various adjuvants have been used along with local anaesthetics to improve postoperative analgesia like pentazocine, ketorolac, morphine, meperidine, fentanyl, tramadol, dexmetedomidne, clonidine, and buprenorphine. With this back ground, the present study was conducted to assess the efficacy of Tramadol as an adjuvant to Lignocaine in Intravenous Regional Anaesthesia for upper limb surgeries. Material and Method- 60 Patient of either sex, between age group of 16 to 60 years and ASA I and II were included in the study. The patients were allocated into two groups (group A and B) depending upon the drug injected intravenously for IVRA. Group A consisted of 30 patients who received 0.5%, 40 ml Lignocaine plus 1 ml NS, Group B consisted of 30 patients who received 0.5%, 40 ml Lignocaine with Tramadol 50 mg in IVRA. Onset of sensory & motor blockade after injection of drug following tourniquet inflation, quality of block, recovery of sensory and motor blockade, duration of postoperative pain after tourniquet deflation was also assessed. The result of this study was subjected to statistical analysis for significance. The statistical methods employed were unpaired-t test and ‘p’ value. Results- Majority of the patients in group A & B were in the age group of 16-35 year. The majority of the patients were male in both the groups. The mean onset of sensory blockade was 4.48 ± 0.99, 2.36 ± 0.507 minutes in group A & B respectively. The mean onset of motor blockade was 11.56 ± 1.35, 11.5±1.07 minutes in group A & B respectively. Block was excellent in 23 cases (76.66%) in group B, as compared to 11 cases (36.66) in group A. Conclusion- On the basis of results obtained in the present study, it can be concluded that addition of tramadol to lignocaine in IVRA shortens the onset & prolongs the recovery of sensory blockade. This combination has definitive advantage in prolonging to postoperative analgesia up to 3 hrs.