Comparison of Tramadol and Buprinorphine as an Adjuvent to Bupivacaine used in Supraclavicular brachial plexus block for upper limb surgeries

To compare the bupivacaine with buprinorphine and bupivacaine with  tramadol mixture in terms of -
•    Onset of block
•    Time to achieve complete block
•    Duration of postoperative analgesia
•    Incidence of side effects
MATERIALS AND METHODS
Selection Criteria
-     ASA physical status I and II patients
-     Age group 20-50 years.
Exclusion Criteria
-    Progressive neurological disorder
-     Patients having liver or kidney disease
-     History of hypersensitivity reaction to study medication
-     Clotting disorder
-     Patients on opioids
-     Patients who are not willing
They were randomly divided into
Group T: 30 ml of 0.25% Bupivacaine 50mg with Tramadol in Supraclavicular Brachial Plexus Block.
Group B: 30 ml of 0.25%Bupivacaine with 100 mcg Buprinorphine in supraclavicular brachial plexus block.
METHODOLOGY
•    Written, informed consent.
•    All patients  received inj. Midazolam 1mg as premedication.
•    The subclavian artery as a guide.
•    Sensory block was tested by Pinprick method.
0=sharp pain
1=touch sensation
2=no sensation
Assessment of motor blockade by using the Bromage 3 point score.
0=normal motor function
1=decreased motor strength with ability to move the fingers
2=complete motor block with inability to move fingers
Vitals parameters were recorded.
Pain assessment by using verbal response score (VRS) -
     0 =complete absence of pain
     10=worst pain
Rescue analgesia (VRS>6) - inj. diclofenac 75mg IM
Patients will be observed for side effects.
Results: Onset of analgesia is fast with tramadol added to bupivacaine and time to achieve complete block without any increase in side- effects.
Addition of Buprinorphine – Enhance the postoperative analgesia than tramadol added to bupivacaine.