The addition of sufentanil, tramadol or clonidine to lignocaine for intravenous regional anaesthesia

This study was designed to evaluate the effect of sufentanil, tramadol or clonidine added to lignocaine for intravenous regional anaesthesia. We investigated the onset and duration of sensory and motor block, the quality of the anaesthesia, intraoperative and postoperative haemodynamics, intraoperative and postoperative pain and sedation. Sixty patients undergoing ambulatory hand surgery received intravenous regional anaesthesia using 35 ml of 0.5% lignocaine and either 5 ml saline (Group L, n = 15); sufentanil 25 micrograms (Group LS, n = 15); tramadol 100 mg (Group LT, n = 15) or clonidine 1 microgram.kg-1 (Group LC, n = 15). Before and after the tourniquet application, haemodynamic data, tourniquet pain, sedation scores and analgesic use were recorded. After tourniquet deflation, haemodynamic data, pain and sedation, time to first analgesic requirement and analgesic use were noted. There were no differences among groups in intraoperative haemodynamic data, the time to recovery of sensory block, the onset and the recovery of motor block, sedation scores or postoperative pain. Compared to the other groups, in Group L the onset of sensory block was longer, the time to initial tourniquet pain was shorter and the intraoperative tourniquet pain scores and use of the opioid were higher (P < 0.05). The quality of anaesthesia in Groups LS, LT and LC was better than in Group L (P < 0.05). In conclusion, the addition of sulfentanil, tramadol or clonidine to lignocaine shortened the onset of the sensory block, delayed the onset time of the tourniquet pain and reduced the intraoperative consumption of opioid, but did not affect postoperative pain.