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ANALGESIA

Tramadol as an Adjuvant to Lidocaine for Axillary Brachial Plexus Block

Olfa Kaabachi, MD^*, Rami Ouezini, MD^*, Walid Koubaa, MD^*, Badii Ghrab, MD^*, Amin Zargouni, MD^*, and Ahmed Ben Abdelaziz, MD

From the *Department of Anesthesiology and Intensive Care Medicine, Kassab Orthopedic Institute, Ksar Said, Tunis, Tunisia; and Department of Statistics, Sahloul Hospital, Sousse, Tunisia.

Address correspondence and reprint requests to Dr. Olfa Kaabachi, Service d'anesthésie réanimation, Institut Kassab d'Orthopédie, Ksar said 2010, Tunis, Tunisia. Address e-mail to olfa.kaabachi{at}gnet.tn or olfa.kaabachi{at}yahoo.fr.

Abstract

BACKGROUND: In this prospective randomized study, we evaluated the effect of tramadol as an adjuvant to axillary block.

METHODS: We studied 102 patients scheduled for hand surgery under axillary block with lidocaine 1.5% (epinephrine 1/200,000) and the addition of either 4 mL saline (control group), 100 mg tramadol and 2 mL saline (TL group), or 200 mg tramadol (TH group).

RESULTS: Onset time was longer in the TH group, 16 ± 7 min (9 ± 3 min in control group; P = 0.01). Sensory block and time for first rescue analgesia were significantly prolonged in the TH group compared with both TL and control groups (265 ± 119 min vs 190 ± 87 min vs 126 ± 48 min; P = 0.018); (734 ± 434 min vs 573 ± 516 min vs 375 ± 316 min; P = 0.02).

CONCLUSIONS: The benefit of block prolongation associated with the addition of 200 mg tramadol to lidocaine during axillary block is limited by the slow onset of the block.