Comparison of the Effects of Lignocaine, Lignocaine Plus Paracetamol, Lignocaine Plus Tramadol in Intravenous Regional Anesthesia

Abstract

INTRODUCTION:Intravenous regional anesthesia is simple, effective technique for upper limb orthopedic surgeries however adjuncts are required to improve its efficacy. AIMS: To compare the effects of adding paracetamol and tramadol as adjunct to lignocaine in intravenous regional anesthesia on onset and regression of sensory and motor blockage, analgesic requirements, duration of analgesia and side effects. PATIENTS AND METHOD: A randomized study was carried out on ninety patients who were undergoing upper limb orthopedic surgery, divided in to three groups: group I (L) received 3mg/kg lignocaine 0.5% diluted up to 40 ml with normal saline, group II (LP) received 3mg/kg lignocaine 0.5% with 300mg paracetamol diluted up to 40 ml with normal saline, group III (LT) received 3mg/kg lignocaine 0.5% with tramadol 100mg diluted up to 40 ml with normal saline. Sensory and motor block onset, regression time, intraoperatively and postoperatively VAS score, duration of analgesia, total analgesic consumption in first 24 hr and side effects noted. Analysis of data based on chi square test and post hoc test. P value < 0.05 considered significant. RESULTS: A total of ninety patients were included in study. The mean age of patients in group I was 32.60±14.8 years, in group II was41.67±16.6 years while in group III was 38.73±13.3 years. Tramadol with lignocaine was found to be significantly better as compared to paracetamol and lignocaine alone had early onset and delayed offset of sensory and motor block. The tramadol group required significantly less number of rescue analgesics in first 24 hours as compared to the other two groups. CONCLUSION: We concluded that as adjuvant tramadol group was accompanied by more rapid onset, longer duration of analgesia provides better quality of anesthesia and lesser number of patients require rescue analgesia intraoperatively as well as postoperatively without any significant side effects.