Comparison of Tramadol and Dexamethasone as admixture to Bupivacaine

Dexamethasone as an adjuvant to local anaesthetics in humans was first reported in 2003. Dexamethasone significantly prolongs the duration of analgesia as the steroids via blocking the nociceptive impulse transmission along the myelinated C-fibres have nerve block prolonging effects. Secondly, most of the studies show that Dexamethasone prolongs the motor blockade beyond that of the analgesia duration when combined with a high concentration of local anaesthetics. Tramadol has been used as an adjunct to local anaesthetics in Axillary brachial plexus block and also in Caudal anaesthesia to extend the duration of postoperative analgesia. In a recent review, Tramadol was described to stimulate serotonin release intrathecally, while inhibiting norepinephrine reuptake centrally. It is also a weak µ- and ¿-opioid receptor agonist, and also blocks voltage gated sodium channels in vitro in a fashion that is not opioid receptor related. The present study was conducted to compare the efficacy of Tramadol and Dexamethasone as an adjuvant to Bupivacaine in Supraclavicular Brachial Plexus block.