The effects of tramadol added to the mixture of local anesthetic for axillary brachial plexus blockade

We purposed to investigate the effects of tramadol added to the mixture of local anesthetic for axillary brachial plexus blockade on the intraoperative visual analog scale (VAS), haemodynamics, side effects, complications, and the need of sedative and postoperative anesthetic and analgesic requirements, side effects, and patients? satisfaction.In this double blind, randomised study, 40 patients in the American Anesthesiology Association (ASA) I-II risk group, between 18-60 years of age were included. Group 1: Levobupivacaine (150 mg, n= 20) + lidocaine (200 mg), group 2: Levobupivacaine (150 mg, n= 20) + lidocaine (200 mg) + tramadol (100 mg). For the purpose of premedication, a standard intravenous midazolam of 0.02-0.03 mg/kg was administered to each patient after monitoring. Brachial plexus blockade was performed with the mixture of local anesthetic, 42 ml using peripheral nerve stimulator. The sensory blockade was evaluated with using a pin-prick test and the motor blockade was evaluated with using Bromage scale and the duration of onset of sensory and motor blockade were recorded. The intraoperative sedative requirements were provided with midazolam respectively and recorded. The first analgesic requirement in 24-hours-postoperative-period (when VAS> 3), side effects, and complications were recorded. Additionally, postoperative patients? satisfaction were recorded after evaluation.There was no significant difference between the groups regarding intraoperative VAS, haemodynamic changes, side effects-complications and sedative drug requirement, the postoperative anesthetic-analgesic efficiency and the patients? satisfaction. The onset of motor blockade of n. medianus at 5.th minute and n. ulnaris at 10.th and 15.th minutes in group 2 were significantly longer than that in group 1 (p< 0.05).After addition of tramadol, 100 mg to local anesthetic solution it was not observed any other effects exlusing a delay in the onset of motor blockade of n. medianus at 5th minute and n. ulnaris at 10th and 15th minutes.