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The addition of tramadol to lidocaine does not reduce tourniquet and postoperative pain during iv regional anesthesia

[L'ajout de tramadol à la lidocaïne ne réduit pas la douleur du garrot pendant l'anesthésie iv régionale, ni la douleur postopératoire]

Grégoire Langlois, MD^*, Jean-Pierre Estèbe, MD PhD^*, Marc E. Gentili, MD MSc^*,, Loik Kerdilès, MD, Philippe Mouilleron, MD and Claude Ecoffey, MD^*

^* From the Department of Anesthesia, Intensive Care and Pain Clinic, (University of Rennes 1), University Hospital of Rennes, France, and
the Centre Médico-Chirurgical Saint–Vincent, Saint-Grégoire, France.

Address correspondence to: Dr. Marc E. Gentili, Centre Médico Chirurgical Saint-Vincent, Avenue Saint Vincent, 35760 Saint-Grégoire, France. Phone: 33 (0) 2 99 23 33 03; Fax: 33 (0) 2 99 23 69 69; E-mail: Marc.Gentili{at}wanadoo.fr

Purpose: We conducted a prospective, randomized, double-blind study to determine whether the combination of tramadol with lidocaine 0.5% had an analgesic effect on tourniquet pain during iv regional anesthesia and also on postoperative pain.

Methods: Thirty patients scheduled for carpal tunnel decompression were included in the study. Each patient received 3 mg•kg^-1 of plain lidocaine 0.5% with 100 mg of tramadol (Group T) or 2 mL of isotonic saline (Group C). The mixture was injected into the isolated and exsanguinated arm. Pain was assessed using a linear visual analog scale and a verbal rate scale during the surgical procedure and the postoperative period (240 min) and subsequently at interview at 24 hr. Analgesic consumption was recorded.

Result: There was no difference in the pain scales and analgesic request at any of the time periods studied.

Conclusion: We conclude, therefore, that for carpal tunnel operation under iv regional anesthesia, the combination of tramadol and lidocaine is not more effective than lidocaine alone.

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