Comparative Study of Tramadol and Nalbuphine as an Adjuvant to Ropivacaine in Supraclavicular Block: A Cross-Sectional Observational Study

Background: Adjuvants are commonly added to local anesthetics to enhance the quality and duration of peripheral nerve blocks. This study compares the effectiveness of tramadol and nalbuphine as adjuvants to ropivacaine in supraclavicular brachial plexus block. Methods: A cross-sectional observational study was conducted on approximately 90 patients undergoing elective upper limb surgeries at Patna Medical College and Hospital from January to December 2024. Patients were randomly divided into two groups: Group T received 0.5% ropivacaine with tramadol (100 mg), and Group N received 0.5% ropivacaine with nalbuphine (10 mg). Onset time, block duration, analgesia duration, and side effects were recorded and compared. Results: Group N (nalbuphine) showed a significantly faster onset of sensory and motor blocks and longer duration of block and analgesia compared to Group T (tramadol). Adverse effects were mild and comparable in both groups. Conclusion: Nalbuphine is a more effective and safer adjuvant than tramadol when used with ropivacaine in supraclavicular blocks, offering prolonged and quality analgesia without significant complications. Keywords: Nalbuphine, Tramadol, Supraclavicular block, Ropivacaine