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VOLUME 4 , ISSUE 1 ( January-April, 2018 ) > List of Articles

ORIGINAL ARTICLE

Comparison of Bupivacaine with Tramadol vs Bupivacaine with Dexamethasone in Supraclavicular Block: A Prospective Randomized Double-blind Study

Vrishali Y Apte, Maya A Jamkar

Keywords : Additive, Dexamethasone, Supraclavicular block, Tramadol

Citation Information : Apte VY, Jamkar MA. Comparison of Bupivacaine with Tramadol vs Bupivacaine with Dexamethasone in Supraclavicular Block: A Prospective Randomized Double-blind Study. J Recent Adv Pain 2018; 4 (1):15-18.

DOI: 10.5005/jp-journals-10046-0095

License: CC BY-ND 3.0

Published Online: 01-09-2017

Copyright Statement:  Copyright © 2018; The Author(s).


Abstract

Introduction There is a list of additives for supraclavicular block to facilitate onset, intensity, and duration of the block, which may also be prudent for postoperative analgesia. Aim To compare dexamethasone and tramadol in combination with bupivacaine in terms of duration of sensory and motor block, onset of block, postoperative duration of analgesia and safety. Materials and methods Sixty patients of American Society of Anesthesiologists (ASA) physical status I and II undergoing below elbow surgery under brachial plexus block were randomly allocated in two groups of 30 each to receive either dexamethasone 8 mg + bupivacaine (0.5%) (0.5 mL/kg) (group I) or tramadol 1 mg/kg + bupivacaine (0.5%) (0.5 mL/kg) (group II). Primary objectives were to study the onset of sensory and motor blockade, duration of sensory and motor blockade, and duration of analgesia. Secondary objective was to study the side effects. Two-sample t-test was used to compare various parameters like onset of sensory blockade, onset of motor blockade, sensory offset, motor offset, and duration of analgesia. Results The onset of sensory blockade in groups I and II (7.86 ± 1.63 vs 8.68 ± 1.74 minutes respectively) and onset of motor blockade (9.63 ± 1.28 minutes in group I and 9.86 ± 1.42 minutes in group II) were statistically comparable while duration of sensory blockade (1038 ± 112.4 minutes in group I and 302.8 ± 27.50 minutes in group II), duration of motor blockade (889.5 ± 89.4 minutes in group I and 274.5 ± 27.08 minutes in group II), and postoperative duration of analgesia (20.43 ± 1.75 hours in group I and 7.08 ± 1.47 hours in group II) were significantly prolonged in group I compared with group II. No significant side effects were seen in any of the groups. Conclusion Addition of dexamethasone to 0.5% bupivacaine in supraclavicular brachial plexus block significantly prolongs the duration of sensory and motor blockade and postoperative duration of analgesia when compared with tramadol as additive. Both the drugs were comparable in terms of safety. How to cite this article Apte VY, Jamkar MA. Comparison of Bupivacaine with Tramadol vs Bupivacaine with Dexamethasone in Supraclavicular Block: A Prospective Randomized Double-blind Study. J Recent Adv Pain 2018;4(1):15-18.

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  1. Murphy DB, McCartney CJ, Chan VW. Novel analgesic adjuvants for brachial plexus block, a systematic review. Anesth Analg 2000 May;90(5):1122-1128.
  2. Karakaya D, Büyükgöz F, Bariş S, Güldoğuş F, Tür A. Addition of fentanyl to bupivacaine prolongs anesthesia and analgesia in axillary brachial plexus block. Reg Anesth Pain Med 2001 Sep-Oct;26(5):434-438.
  3. Wakhlo R, Gupta V, Raina A, Gupta SD, Lahori VU. Supraclavicular plexus block: effect of adding tramadol or butorphanol as an adjuncts to local anaesthetic on motor and sensory block and duration of postoperative analgesia. J Anaesth Clin Pharmacol 2009 Jan;25(1):17-20.
  4. VHYPERLINK “http://www.ncbi.nlm.nih.gov/pubmed/?term=van%20den%20Berg%20AA%5BAuthor%5D&cauthor=true&cauthor_uid=9926184” van den Berg AA, Halliday E, Lule EK, Baloch MS. The effects of tramadol on postoperative nausea, vomiting and headache after ENT surgery. A placebo-controlled comparison with equipotent doses of nalbuphine and pethidine. Act Anaesthesiol Scand 1999 Jan;43(1):28-33.
  5. Shrestha BR, Maharjan SK, Tabedar S. Supraclavicular brachial plexus block with and without dexamethasone – a comparative study. Kathmandu Univ Med J (KUMJ) 2003 Jul-Sep;1(3):158-160.
  6. Movafegh A, Razazian M, Hajimaohamadi F, Meysamic A. Dexamethasone added to lidocaine prolongs axillary brachial plexus blockade. Anesth Analg 2006 Jan;102(1):263-267.
  7. Parrington SJ, O'Donnell D, Chan VW, Brown-Shreves D, Subramanyam R, Qu M, Brull R. Dexamethasone added to mepivacaine prolongs the duration of analgesia after supraclavicular brachial plexus blockade. Reg Anesth Pain Med 2010 Sep-Oct;35(5):422-426.
  8. Islam SM, Hossain MHMD, Maruf AA. Effect of addition of dexamethasone to local anaesthetics in supraclavicular brachial plexus block. JAFMC Bangladesh 2011 Jun;7(1):11-14.
  9. Pathak RG, Satkar AP, Khade RM. Supraclavicular brachial plexus block with and without dexamethasone – a comparative study. IJSRP 2012 Dec;2(12):1-7.
  10. Kim YJ, Lee GY, Kim DY, Kim CH, Baik HJ, Heo S. Dexamethasone added to levobupivacaine improves postoperative analgesia in ultrasound guided inter-scalene brachial plexus blockade for arthroscopic shoulder surgery. Korean J Anesthesiol 2012 Feb;62(2):130-134.
  11. Dar FA, Najar MR, Jan N. Effect of addition of dexamethasone to ropivacaine in supraclavicular brachial plexus blockade. Indian J Pain 2013;27(3);165-169.
  12. Biradar PA, Kaimar P, Gopalakrishna K. Effect of dexamethasone added to lidocaine in supraclavicular brachial plexus block: a prospective, randomised, double-blind study. Indian J Anaesth 2013 Mar;57(2):180-184.
  13. Choi S, Rodseth R, McCartney CJ. Effects of dexamethasone as a local anaesthetic adjuvant for brachial plexus block: a systematic review and meta-analysis of randomized trials. Br J Anaesth 2014 Mar;112(3):427-439.
  14. Kapral S, Gollmann G, Waltl B, Likar R, Sladen RN, Weinstabl C, Lehofer F. Tramadol added to mepivacaine prolongs the duration of an axillary brachial plexus blockade. Anaesth Analg 1999 Apr;88(4):853-856.
  15. Robaux S, Blunt C, Viel E, Cuvillon P, Nouguier P, Dautel G, Boileau S, Girard F, Bouaziz H. Tramadol added to 1.5% mepivacaine for axillary brachial plexus block improves postoperative analgesia. Anaesth Analg 2004 Apr;98(4):1172-1177.
  16. Chattopadhyay S, Mitra LG, Biswas BN, Majumder P. Tramadol as an adjuvant for brachial plexus block. J Anaesth Clin Pharmacol 2007;23(2):187-189.
  17. Shrestha BR, Maharjan SK, Shrestha S, Gautam B, Thapa C, Thapa PB, Joshi MR. Comparative study between tramadol and dexamethasone as an admixture to bupivacaine in supraclavicular brachial plexus block. JNMA J Nepal Med Assoc 2007 Oct-Dec;46(168):158-164.
  18. Trabelsi W, Lebbi A, Romdhani C, Naas I, Sammoud W, Elaskri H, Labbene I, Ferjani M. Dexamethasone provides longer analgesia than tramadol when added to lidocaine after ultrasound guided supraclavicular brachial plexus block. A randomized double blinded study. Analg Resusc Curr Res 2013 Jul;2:2.
  19. Peters JL, Large RG. A randomised control trial evaluating in- and outpatient pain management programmes. Pain 1990 Jun;41(3):283-293.
  20. Das G. Interventional pain management. Ind J Pain 2011;25:9-11.
  21. Turk DC, Wilson HD, Cahana A. Treatment of chronic non-cancer pain. Lancet 2011 Jun;377(9784):2226-2235.
  22. Aström M. Generalized anxiety disorder in stroke patients. A 3-year longitudinal study. Stroke 1996 Feb;27(2):270-275.
  23. Oladiji JO, Akinbo SR, Aina OF, Aiyejusunle CB. Risk factors of post-stroke depression among stroke survivors in Lagos, Nigeria. Afr J Psychiatry (Johannesbg) 2009 Feb;12(1):47-51.
  24. Chemerinski E, Robinson RG. The neuropsychiatry of stroke. Psychosomatics 2000 Jan-Feb;41(1):5-14.
  25. Angelelli P, Paolucci S, Bivona U, Piccardi L, Ciurli P, Cantagallo A, Antonucci G, Fasotti L, Di Santantonio A, Grasso MG, et al. Development of neuropsychiatric symptoms in poststroke patients: a cross-sectional study. Acta Psychiatr Scand 2004 Jul;110(1):55-63.
  26. Almeida OP, Xiao J. Mortality associated with incident mental health disorders after stroke. Aust N Z J Psychiatry 2007 Mar;41(3):274-281.
  27. Smitherman, TA.; Baskin, SM. Depression and anxiety in migraine patients. Mount Royal (NJ): American Migraine Foundation; 2015.
  28. Mehlsteibl D, Schankin C, Hering P, Sostak P, Straube A. Anxiety disorders in headache patients in a specialised clinic: prevalence and symptoms in comparison to patients in a general neurological clinic. J Headache Pain 2011 Jun;12(3):323-329.
  29. Merikangas KR, Angst J, Isler H. Migraine and psychopathology. Results of the Zurich cohort study of young adults. Arch Gen Psychiatry 1990 Sep;47(9):849-853.
  30. Beghi E, Bussone G, D'Amico D, Cortelli P, Cevoli S, Manzoni GC, Torelli P, Tonini MC, Allais G, De Simone R, et al. Headache, anxiety and depressive disorders: the HADAS study. J Headache Pain 2010 Apr;11(2):141-150.
  31. Corchs F, Mercante JP, Guendler VZ, Vieira DS, Masruha MR, Moreira FR, Bernik M, Zukerman E, Peres MF. Phobias, other psychiatric comorbidities and chronic migraine. Arq Neuropsiquiatr 2006 Dec;64(4):950-953.
  32. Song TJ, Cho SJ, Kim WJ, Yang KI, Yun CH, Chu MK. Anxiety and depression in tension-type headache: a population-based study. PLoS One 2016 Oct;11(10):e0165316.
  33. Puca F, Genco S, Prudenzano MP, Savarese M, Bussone G, D'Amico D, Cerbo R, Gala C, Coppola MT, Gallai V, et al. Psychiatric comorbidity and psychosocial stress in patients with tension-type headache from headache centers in Italy. The Italian Collaborative Group for the Study of Psychopathological Factors in Primary Headaches. Cephalalgia 1999 Apr;19(3):159-164.
  34. Holroyd KA, Stensland M, Lipchik GL, Hill KR, O'Donnell FS, Cordingley G. Psychosocial correlates and impact of chronic tension-type headaches. Headache 2000 Jan;40(1):3-16.
  35. Borkovec, TD.; Alcaine, O.; Behar. E. Avoidance theory of worry and generalized anxiety disorder. In: Heimberg RG, Turk CL, Mennin DS, editors. Generalized anxiety disorder in research and practice. New York: Guilford Press; 2004. pp. 77-108.
  36. Behar E, DiMarco ID, Hekler EB, Mohlman J, Staples AM. Current theoretical models of generalized anxiety disorders (GAD): conceptual review and treatment implications. J Anxiety Disord 2009 Dec;23(8):1011-1023.
  37. McWiliams LA, Goodwin RD, Cox BJ. Depression and anxiety associated with three pain conditions: results from a nationally representative sample. Pain 2004 Sep;111(1-2):77-83.
  38. Daniali S, Azadbakht L, Mostafavi F. Relationship between body satisfaction with self esteem and unhealthy body weight management. J Educ Health Promot 2013 Jul;2:29.
  39. Huang JS, Norman GJ, Zabinski MF, Calfas K, Patrick K. Body image and self-esteem among adolescents undergoing an intervention targeting dietary and physical activity behaviors. J Adolesc Health 2007 Mar;40(3):245-251.
  40. Wang, Y.; Wu, Y.; Wilson, RF.; Bleich, S.; Cheskin, L.; Weston, C.; Showell, N.; Fawole, O.; Lau, B.; Segal, J. Childhood obesity prevention programs: comparative effectiveness review and meta-analysis. Rockville (MD): Agency for Healthcare Research and Quality (US); 2013. [cited 2013 Jun]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK148737/.
  41. Khan MA, Mahomed MF, Ashshi AM, Faiz A. Drug resistance patterns of Acinetobacter baumannii in Makkah, Saudi Arabia. Pak J Med Res 2012 Oct-Dec;51(4):127-131.
  42. Shields RK, Clancy CJ, Gillis LM, Kwak EJ, Silveira FP, Massih RC, Eschenauer GA, Potoski BA, Nguyen MH. Epidemiology, clinical characteristics and outcomes of extensively drug-resistant Acinetobacter baumannii infections among solid organ transplant recipients. PLoS One 2012 Dec;7(12):e52349.
  43. Prashanth K, Badrinath S. In vitro susceptibility pattern of Acinetobacter species to commonly used cephalosporins, quinolones and aminoglycosides. Indian J Med Microbiol 2004 Apr-Jun;22(2):97-103.
  44. Armin S, Karimi A, Fallah F, Tabatabaii RS, Alfatemi SM, Khiabanirad P, Shiva F, Fahimzad A, Rahbar M, Mansoorghanaii R, et al Antimicrobial resistance pattern of Acinetobacter baumannii, Pseudomonas aeruginosa and Staphylococcus aureus isolated from patients with nosocomial infection admitted to Tehran hospitals. Arch Pediatr Infect Dis 2015 Oct;3(4):e32554.
  45. Qureshi ZA, Abbasi SA, Mirza IA, Malik N, Amjad A, Sattar A, Ikram A. Antimicrobial susceptibility pattern of Acinetobacter species-one year experience in a tertiary care setting. Infect Dis J 2011 Mar;20(1):269-272.
  46. Spencer L, Bubner T, Bain E, Middleton P. Screening and subsequent management for thyroid dysfunction pre-pregnancy and during pregnancy for improving maternal and infant health. Cochrane Database Syst Rev 2015 Sep;9:CD011263.
  47. Li M, Yao Q, Xing A. A clinical analysis of 188 cases of pregnancy complicated with critical heart disease. Zhong Nan Da Xue Xue Bao Yi Xue Ban 2014 Nov;39(11):1145-1150.
  48. Bhatla N, Lal S, Behera G, Kriplani A, Mittal S, Agarwal N, Talwar KK. Cardiac disease in pregnancy. Int J Gynaecol Obstet 2003 Aug;82(2):153-159.
  49. Gelson E, Curry R, Gatzoulis MA, Swan L, Lupton M, Steer P, Johnson M. Effect of maternal heart disease on fetal growth. Obstet Gynecol 2011 Apr;117(4):886-891.
  50. Arora N, Kausar H, Jana N, Mandal S, Mukherjee D, Mukherjee R. Congenital heart disease in pregnancy in a low-income country. Int J Gynaecol Obstet 2015 Jan;128(1):30-32.
  51. Report of the National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy. Am J Obstet Gynecol 2000 Jul;183(1):S1-S22.
  52. Agency for Healthcare Research and Quality. Management of chronic hypertension during pregnancy. Evidence Report/Technology Assessment no.14. AHRQ publication no. 00-E011. Rockville, MD: Agency for Healthcare Research and Quality; 2000.
  53. Ferrer RL, Sibai BM, Mulrow CD, Chiquette E, Stevens KR, Cornell J. Management of mild chronic hypertension during pregnancy: a review. Obstet Gynecol 2000 Nov;96(5 Pt 2):849-860.
  54. Sridharan R, Murthy BN. Prevalence and pattern of epilepsy in India. Epilepsia 1999 May;40(5):631-636.
  55. Viale L, Allotey J, Cheong-See F, Arroyo-Manzano D, McCorry D, Bagary M, Mignini L, Khan KS, Zamora J, Thangaratinam S, et al. Epilepsy in pregnancy and reproductive outcomes: a systematic review and meta-analysis. Lancet 2015 Nov;386(10006):1845-1852.
  56. Smyth A, Oliveira GH, Lahr BD, Bailey KR, Norby SM, Garovic VD. A systematic review and meta-analysis of pregnancy outcomes in patients with systemic lupus erythematosus and lupus nephritis. Clin J Am Soc Nephrol 2010 Nov;5(11):2060-2068.
  57. Hazes JM, Coulie PG, Geenen V, Vermeire S, Carbonnel F, Louis E, Masson P, De Keyser F. Rheumatoid arthritis and pregnancy: evolution of disease activity and pathophysiological considerations for drug use. Rheumatology (Oxford) 2011 Nov;50(11):1955-1968.
  58. Velu PP, Gravett CA, Roberts TK, Wagner TA, Zhang JS, Rubens CE, Gravett MG, Campbell H, Rudan I. Epidemiology and aetiology of maternal bacterial and viral infections in low- and middle-income countries. J Glob Health 2011 Dec;1(2):171-188.
  59. UNAIDS: UNAIDS report on the global AIDS epidemic. 2010. Available from http://www.unaids.org/globalreport/Global_report.htm
  60. Ioannidis JP, Abrams EJ, Ammann A, Bulterys M, Goedert JJ, Gray L, Korber BT, Mayaux MJ, Mofenson LM, Newell ML, et al. Perinatal transmission of human immunodeficiency virus type 1 by pregnant women with RNA virus loads <1000 copies/ml. J Infect Dis 2001 Feb;183(4):539-545.
  61. Anglemyer A, Rutherford GW, Horvath T, Baggaley RC, Egger M, Siegfried N. Antiretroviral therapy for prevention of HIV transmission in HIV-discordant couples. Cochrane Database Syst Rev 2013 Apr;4:CD009153.
  62. Rimoin DL, Connor JM, Pyeritz RE, Korf BR. Emery and Rimoin's principles and practice of medical genetics. Churchill Livingstone Elsevier; 2007.
  63. Verma IC, Puri RD. Global burden of genetic disease and the role of genetic screening. Semin Fetal Neonatal Med 2015 Oct;20(5):354-363.
  64. White SJ, Boldt KL, Holditch SJ, Poland GA, Jacobson RM. Measles, mumps, and rubella. Clin Obstet Gynecol 2012 Jun;55(2):550-559.
  65. American College of Obstetricians and Gynecologists. ACOG educational bulletin: viral hepatitis in pregnancy. Int J Gynaecol Obstet 1998 Nov;63:195-202.
  66. Geeta MG, Riyaz A. Prevention of mother to child transmission of hepatitis B infection. Indian Pediatr 2013;50:189-192.
  67. Swamy GK, Beigi RH. Maternal benefits of immunization during pregnancy. Vaccine 2015 Nov;33(47):6436-6440.
  68. Sukumaran L, McCarthy NL, Kharbanda EO, McNeil MM, Naleway AL, Klein NP, Jackson ML, Hambidge SJ, Lugg MM, Li R, et al. Association of Tdap vaccination with acute events and adverse birth outcomes among pregnant women with prior tetanus-containing immunizations. JAMA 2015 Oct;314(15):1581-1587.
  69. Singru SA, Tilak VW, Gandham N, Bhawalkar JS, Jadhav SL, Pandve HT. Study of susceptibility towards Varicella by screening for the presence of IgG antibodies among nursing and medical students of a Tertiary Care Teaching Hospital in Pune, India. J Glob Infect Dis 2011 Jan-Mar;3(1):37-41.
  70. Nathwani D, Maclean A, Conway S, Carrington D. Varicella infections in pregnancy and the newborn. A review prepared for the UK Advisory Group on Chickenpox on behalf of the British Society for the Study of Infection. J Infect 1998;36 (Suppl 1):59-71.
  71. Michaan N, Amzallag S, Laskov I, Cohen Y, Fried M, Lessing JB, Many A. Maternal and neonatal outcome of pregnant women infected with H1N1 influenza virus (swine flu). J Matern Fetal Neonatal Med 2012 Feb;25(2):130-132.
  72. Smith NM, Bresee JS, Shay DK, Uyeki TM, Cox NJ, Strikas RA. Prevention and control of influenza: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 2006 Jul;55(RR-10):1-42.
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