The effectiveness of adding tramadol versus fentanyl as an adjuvant to bupivacaine on brachial plexus block: A double blind, randomized controlled trial

Background: Anesthesia and analgesia for surgeries to the upper extremity are commonly provided using the brachial plexus block. Tramadol and fentanyl are used to fasten the onset and prolong the duration of the axillary brachial plexus block, but their relative ef ficacy is not well established. Methodology: The study was conducted on 63 patients who underwent hand, wrist and forearm sur- geries. Patients were randomly allocated in to three groups. Group T (n = 21) received 100 mg tramadol + 0.25% bupivacaine, group F (n = 21) received 50 mg fentanyl + 0.25% bupivacaine and group B (n = 21) received 0.25% bupivacaine. Parametric data and non -parametric data was analyzed by ANOVA and Kruskal-Wallis H tests respectively. Chi-square test was used to assess the association of dependent and independent variables of categorical data. P -values less than 0.05 were considered as statistically signi ficant. Result: There was no statistically signi ficant difference regarding demographic variables. Time onset of sensory and motor block was shorter in group F than group T and group B (p < 0.001). Duration of sensory blockade was longer in the group T than group F and group B (P < 0.001). Time to first analgesic request was signi ficantly longer in group T and F when compared with group B and signi ficantly longer in group T when compared with group F (P < 0.001). Conclusion: Addition of tramadol or fentanyl to bupivacaine in axillary block fastens the onset and prolongs its duration. Tramadol is superior to fentanyl in terms of duration. Trial registration number: PACTR202001635673534.