Comparison of 0.5% Lignocaine with Tramadol and with Nalbuphine for Day Care IVRA in Upper Limb: an Interventional Study

Background and objectives: IVRA is a good alternative to brachial block in upper limb surgeries for day-care patients posted for minor hand and forearm surgeries. We compare two adjuvants to 0.5% lignocaine in 30 patients. The objective was to determine the difference if any, in the analgesic contribution of tramadol versus nalbuphine as adjuvants. Methods:In this randomized double-blind study, 90 patients aged 20-60 years, ASA I-II, both sexes, who were posted for minor hand and forearm surgeries in Fr. Muller Medical College Hospital were allotted into three groups of 30 each: group N received lignocaine 0.5 % and10 mg nalbuphine mixture, group T received lignocaine 0.5% with 100 mg tramadol and group L with plain lignocaine 0.5%.The onset, duration of both sensory and motor blocks, time of first analgesic request postoperatively and complications were recorded. Results:There was a statistically significant early onset of action with significant prolongation in the mean duration of sensory and motor blocks in group T and group N compared with group L (P< 0.001). The results observed in both groups were comparable. There was an increase in the mean time of first analgesic request in group T and group N compared with group L (P< 0.001). Conclusion:Nalbuphine and tramadol as adjuvants to lignocaine in IVRA resulted in early onset and prolongation of the duration of both sensory and motor blocks with insignificant complications. nalbuphine had the longest duration time of postoperative analgesia.