JOURNAL HOME CME HOME THIS MONTH PAST ISSUES ETOC COLLECTIONS AUTHORS REVIEWERS EDITORIAL BOARD FEEDBACK RSS HELP
		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) En Espanol Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (31) Citing Articles via Google Scholar Google Scholar Articles by Kapral, S. Articles by Lehofer, F. Search for Related Content PubMed PubMed Citation Articles by Kapral, S. Articles by Lehofer, F.

---

REGIONAL ANESTHESIA AND PAIN MANAGEMENT

Tramadol Added to Mepivacaine Prolongs the Duration of an Axillary Brachial Plexus Blockade

Stephan Kapral, MD^*, Gabriele Gollmann, MD, Barbara Waltl, MD^*, Rudolf Likar, MD, Robert N. Sladen, MD^§, Christian Weinstabl, MD^*, and Franz Lehofer, MD

*Department of Anesthesia and General Intensive Care, University of Vienna, Vienna; Department of Anesthesia, DOKH Friesach; Department of Anesthesia and General Intensive Care, LKH Klagenfurt, Klagenfurt, Austria; and §Department of Anesthesiology, Columbia-Presbyterian Medical Center, New York, New York

Address correspondence and reprint requests to Stephan Kapral, MD, Department of Anesthesia and General Intensive Care, University of Vienna, 18-20, Waehringer Guertel, A-1090 Vienna, Austria. Address e-mail to Stephan.Kapral{at}univie.ac.at

Tramadol is an analgesic drug that is antagonized by ₂-adrenoceptor antagonists, as well as opioid antagonists. We hypothesized that tramadol might produce effects on an axillary brachial plexus blockade similar to those of clonidine. We designed a prospective, controlled, double-blinded study to assess the impact of tramadol added to mepivacaine on the duration of an axillary brachial plexus blockade. After institutional approval and informed consent, 60 patients (ASA physical status I or II) scheduled for forearm and hand surgery after trauma under brachial plexus anesthesia were included in the study. Patients were randomly assigned to receive either 40 mL of mepivacaine 1% with 2 mL of isotonic sodium chloride solution (Group A, n = 20); 40 mL of mepivacaine 1% with 100 mg of tramadol (Group B, n = 20); or 40 mL of mepivacaine 1% with 2 mL of isotonic sodium chloride solution and 100 mg of tramadol IV (Group C, n = 20). Sensory block, motor block, and hemodynamics were recorded before and 5, 10, 30, 60, 120, 180, and 360 min after local anesthetic injection. Duration of sensory and motor block was significantly longer (P < 0.01; P < 0.05) in Group B (299 ± 84 and 259 ± 76 min) than in Group A (194 ± 35 and 181 ± 24 min) and Group C (187 ± 35 and 179 ± 16 min). There was no difference in onset of sensory and motor blockade among groups. Hemodynamics remained unchanged in all patients throughout the study period. We conclude that the addition of tramadol prolongs the duration of brachial plexus block without side effects. Tramadol may be an alternative to epinephrine or clonidine as an adjuvant to local anesthesia for an axillary block.

Implications: This study demonstrates that the admixture of 100 mg of tramadol with mepivacaine 1% for brachial plexus block provides a pronounced prolongation of blockade without side effects. Our data support a specific analgesic effect of tramadol on peripheral nerves.

This article has been cited by other articles:

				M. R. Khajavi, S. B. M. Aghili, R. S. Moharari, A. Najafi, R. Mohtaram, P. Khashayar, and M. Mojtahedzade Subcutaneous Tramadol Infiltration at the Wound Site Versus Intravenous Administration after Pyelolithotomy Ann. Pharmacother., March 1, 2009; 43(3): 430 - 435. [Abstract] [Full Text] [PDF]

				O. Kaabachi, R. Ouezini, W. Koubaa, B. Ghrab, A. Zargouni, and A. B. Abdelaziz Tramadol as an Adjuvant to Lidocaine for Axillary Brachial Plexus Block Anesth. Analg., January 1, 2009; 108(1): 367 - 370. [Abstract] [Full Text] [PDF]

				A. Zeidan, R. Kassem, N. Nahleh, H. Maaliki, M. El-khatib, M. M.R.F. Struys, and A. Baraka Intraarticular Tramadol-Bupivacaine Combination Prolongs the Duration of Postoperative Analgesia After Outpatient Arthroscopic Knee Surgery Anesth. Analg., July 1, 2008; 107(1): 292 - 299. [Abstract] [Full Text] [PDF]

				A. Movafegh, M. Razazian, F. Hajimaohamadi, and A. Meysamie Dexamethasone Added to Lidocaine Prolongs Axillary Brachial Plexus Blockade Anesth. Analg., January 1, 2006; 102(1): 263 - 267. [Abstract] [Full Text] [PDF]

				S. Mannion, S. O'Callaghan, D. B. Murphy, and G. D. Shorten Tramadol as adjunct to psoas compartment block with levobupivacaine 0.5%: a randomized double-blinded study Br. J. Anaesth., March 1, 2005; 94(3): 352 - 356. [Abstract] [Full Text] [PDF]

				H. Altunkaya, Y. Ozer, E. Kargi, I. Ozkocak, M. Hosnuter, C. B. Demirel, and O. Babuccu The Postoperative Analgesic Effect of Tramadol When Used as Subcutaneous Local Anesthetic Anesth. Analg., November 1, 2004; 99(5): 1461 - 1464. [Abstract] [Full Text] [PDF]

				S. Robaux, C. Blunt, E. Viel, P. Cuvillon, P. Nouguier, G. Dautel, S. Boileau, F. Girard, and H. Bouaziz Tramadol Added to 1.5% Mepivacaine for Axillary Brachial Plexus Block Improves Postoperative Analgesia Dose-Dependently Anesth. Analg., April 1, 2004; 98(4): 1172 - 1177. [Abstract] [Full Text] [PDF]

				J. A. Alhashemi and A. M. Kaki Effect of intrathecal tramadol administration on postoperative pain after transurethral resection of prostate Br. J. Anaesth., October 1, 2003; 91(4): 536 - 540. [Abstract] [Full Text] [PDF]

				H. Altunkaya, Y. Ozer, E. Kargi, and O. Babuccu Comparison of local anaesthetic effects of tramadol with prilocaine for minor surgical procedures Br. J. Anaesth., March 1, 2003; 90(3): 320 - 322. [Abstract] [Full Text] [PDF]

				H. Iskandar, E. Guillaume, F. Dixmerias, B. Binje, S. Rakotondriamihary, R. Thiebaut, and P. Maurette The Enhancement of Sensory Blockade by Clonidine Selectively Added to Mepivacaine After Midhumeral Block Anesth. Analg., September 1, 2001; 93(3): 771 - 775. [Abstract] [Full Text] [PDF]

				P. O. Talke, E. P. Lobo, R. Brown, and C. A. Richardson Clonidine-Induced Vasoconstriction in Awake Volunteers Anesth. Analg., August 1, 2001; 93(2): 271 - 276. [Abstract] [Full Text] [PDF]

				Y.-C. Tsai, P.-J. Chang, and I-M. Jou Direct Tramadol Application on Sciatic Nerve Inhibits Spinal Somatosensory Evoked Potentials in Rats Anesth. Analg., June 1, 2001; 92(6): 1547 - 1551. [Abstract] [Full Text] [PDF]

				I. Acalovschi, T. Cristea, S. Margarit, and R. Gavrus Tramadol Added to Lidocaine for Intravenous Regional Anesthesia Anesth. Analg., January 1, 2001; 92(1): 209 - 214. [Abstract] [Full Text] [PDF]

				D. B. Murphy, C. J. L. McCartney, and V. W. S. Chan Novel Analgesic Adjuncts for Brachial Plexus Block: A Systematic Review Anesth. Analg., May 1, 2000; 90(5): 1122 - 1128. [Abstract] [Full Text] [PDF]

Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999