Tramadol as an adjuvant to intravenous regional anesthesia with lignocaine

OBJECTIVE: To assess the effect of different doses of tramadol when added to lignocaine during intravenous regional anesthesia (IVRA).

METHODS: Sixty patients, scheduled for hand surgery under IVRA in King Fahd University Hospital, Al-Khobar, Saudi Arabia from January 2006 to January 2007 were randomly allocated into 3 groups (20 patients each) in a double blind controlled study. All patients received 0.5% lignocaine, 40ml plus 2ml of a study solution containing either isotonic saline control group, or tramadol 50mg (group T50) or tramadol 100 mg (group T100). Hemodynamic changes, sensory and motor block onset and recovery times, tourniquet tolerance time, the quality of intraoperative anesthesia and the duration of postoperative analgesia were assessed.

RESULTS: All patients, 20 in each group completed the study period. Patients who received tramadol had earlier onset of sensory block (5.2 +/= 1.2; 4.9 +/= 1.2 min in the T50; and T100 groups) compared with the control group (7.6 +/= 1.4 min). Patients who received 100mg of tramadol had better tolerance of tourniquet (p=0.011), and less intraoperative fentanyl supplementation (p=0.042). They had also a longer time to the first postoperative analgesic request (p=0.001) compared with the control group.

CONCLUSION: Tramadol 100 mg is a beneficial additive to lignocaine for IVRA since it shortened the onset of sensory block, enhanced the tourniquet tolerance and improved the perioperative analgesia.