Comparative Study between Dexamethasone and Tramadol As an Adjuvant to Ropivacaine Vs Ropivacaine Alone In USG Guided Supraclavicular Block in Upper Limb Surgeries

Abstract

Background: Brachial plexus block provides superior quality of intraoperative and postoperative analgesia and stable hemodynamics over general anesthesia. Various adjuvants have been used to prolong effects of local anesthetics like epinephrine, midazolam, magnesium sulfate, alpha-2 agonists i.e. Clonidine and dexmedetomidine, dexamethasone and tramadol. Aims & Objective: To compare the efficacy of tramadol and dexamethasone on the characteristics of the block and its effect on postoperative analgesia when added as an adjuvant to ropivacaine in USGguided supraclavicular brachial plexus block. Materials & Methods: Eighty patients belonging to American Society of Anaesthesiologists (ASA) Grade I, II and III, aged between 20 to 55 years, scheduled for undergo elective upper limb surgeries under supraclavicular brachial plexus block were enrolled in this study. Patients were equally divided into two groups : group S received 0.5% ropivacaine 30ml with Dexamethasone 2ml (8mg) and tramadol 2ml (100 mg) And group C received 0.5% ropivacaine 30ml with + normal saline 4ml. Onset and duration of sensory and motor block , duration of postoperative analgesia and any complications were observed. Results: In our study both groups were comparable with respect to their demographic profile of patients, duration of surgery and ASA status. Onset of sensory block was earlier in group S than group C (3.15 ± 0.69 minutes and 7.55± 0.89 minutes respectively, p =0.004). Onset and duration of motor block and postoperat ive analgesia were longer in group S as compared to group C (5.01± 1.33 & 12.32± 0.75 minutes respectively, P= 0.001 and 14.44± 0.635 and 8.24± 0.873
hours respectively, p =0.001 for motor block and 16.53± 0.635 and 10.45 ± 0.681 minutes respectively, p= 0.001for postoperative analgesia). No ignificant side effects were noted. Conclusion: Dexamethasone and tramadol when added to ropivacaine in supraclavicular brachial plexus lock prolongs onset and duration of sensory and motor block and postoperative analgesia significantly with minimal side effects.