Abstract

ATRACURIUM WITH TRAMADOL, OR KETOROLAC, AS AN ADJUNCT TO LOW DOSE LIGNOCAINE, IN INTRAVENOUS REGIONAL ANESTHESIA: A COMPARATIVE STUDY

Ketki Jandial* and Shagufta Tabassum

ABSTRACT

Background: The inability to provide effective postoperative analgesia is one of the major disadvantages of intravenous regional anesthesia (IVRA). Higher dose of lignocaine has been reported to cause toxicity and convulsions. Therefore this study was proposed to evaluate the efficacy of Atracurium as adjuvant with tramadol or Ketorolac in reducing the dose of lignocaine used for intravenous regional anesthesia. Methods: The study was done using randomized clinical trial method in Department of Anaesthesia, Government Medical College, Jammu, J&K, for a period of 6 months, on 75 patients, under elective surgery on forearm and hand, in the age group of 18-60 yrs of either sex and divided into three equal sized groups. Group I patients received 40ml of 0.5% lignocaine. Group II received 40 ml of 0.25% lignocaine with 2 mg Atracurium and 50 mg tramadol while in Group III, tramadol was replaced with 30 mg of Ketorolac. Results: Mean time of onset of motor block, as well as sensory block was delayed in group II and III and was statistically significant (p< 0.001) in comparison to group I. The difference in VAS was found insignificant between group I & II, however intra-operative degree of analgesia in group II and III was comparable to group I. Conclusions: The use of 0.25% lignocaine and Atracurium with tramadol or Ketorolac provides comparable analgesia to 0.5% lignocaine used alone.

Keywords: Intravenous Regional Anesthesia, Lignocaine, Ketorolac, Tramadol, Atracurium.