A comparative double blind study of tramadol and fentanyl as adjuvants to lignocaine for intravenous regional anesthesia for forearm orthopedic surgeries

Introduction: IVRA is safe, technically simple, and cost effective technique compared to general anaesthesia with success rates of 94 to 98% for upper and lower limb surgeries. It also provides bloodless field during surgery. To overcome these disadvantages various adjuvants have been tried. We compared Fentanyl and tramadol as adjuvants to lignocaine for IVRA for upper limb surgeries. Material and Method: After approval from institutional ethical committee, 60 patients of either sex belonging to ASA grade I and II, in the age range of 20 to 60 years scheduled to undergo upper limb orthopaedic surgery either elective or emergency were included in the study. All the patients were administered intravenous regional anaesthesia (IVRA) after obtaining written informed consent. Patients enrolled in the study were divided into 2 groups of 30 each by a computer generated Randomization program. Group LF-received 40 ml of 0.5% Lignocaine with Fentanyl 1 ug/kg. Group LT-received 40 ml of 0.5% Lignocaine with Tramadol 1 mg/kg. Double tourniquet technique was used. The arm was exsanguinated with Eschmark bandage and proximal cuff was inflated followed by injection of the study drug. Parameters observed were time of onset of sensory and motor block, intraoperative conditions post operative analgesia and adverse effects. Data was expressed as mean ± SD (Standard Deviation) of statistical analysis. Statistical Analysis was done by using Discriptive and Inferencial statistics using chi-square test and students unpaired t-test. The software used in analysis were SPSS 17.0 version and Graph Pad Space Prism 5.0 and results were tested at 5% level of significance. Results: Patients were comparable demographically. Mean values of onset of sensory blockade was 6.76 ± 1.30 min in Group LT and 7.13 ± 0.81 min in Group LF