Comparison of butorphanol and tramadol as an adjuvant to local anesthetic drug in axillary brachial plexus block

Background With the advent of opioid receptors, a variety of opioid agents are added to local anesthetic mixtures used in peripheral blocks to improve the quality and duration of block. In this study, we compared the effect of butorphanol and tramadol as adjuvant agents for orthopedic upper extremity surgery. Patients and methods This study was carried out on 50 patients aged between 18 and 60 years, of American Society of Anesthesiologists grades I and II, of either sexes in each group, undergoing orthopedic upper limb surgeries through axillary brachial plexus block. An injection of butorphanol 2 mg (group B) and that of tramadol 100 mg (group T) were added to local anesthetic mixture. Onset of sensory and motor blockade, extent of blockade, and occurrence of any complications were studied in both groups. All patients were observed for analgesia postoperatively by visual analog scale pain score. Results In our study, the onset time (minutes) of sensory and motor blockade was delayed in group B (8.76±1.0 and 5.86±0.71, respectively) as compared with group T (7.54±0.88 and 4.6±0.73, respectively). In group B, the duration of sensory block (291.24±48.51 min) was longer than group T (160.42±12.66 min). Duration of analgesia postoperatively (first rescue analgesic) was 619.96±26.96 min in group B, whereas it was 290.2±20.38 min in group T. Conclusion Butorphanol is more potent and produces longer duration of postoperative analgesia than tramadol, with an extra advantage of sedation and calmness.