ABSTRACT
Dexmedetomidine is approximately 8 time more selective toward the alpha 2-adrenoceptors than clonidine. It decreases anaesthetic requirements by up to 90% and induces/analgesia in patients. Tramadol, a centrally acting analgesic, might have local anaesthetic properties as do some opioid drugs. We designed this study to evaluate the adjuvant effect of dexmedetomidine or tramadol when added to local anaesthetc in IV regional anaesthesia. Forty five patients undergoing hand or forearm surgery were randomly assigned to 3 groups to receive IVRA. Each group 15 patients, lidocaine 0.5% group [group L], a mixture of 0.5% lidocaine and 0.25% tramadol [group TL] or mixture of 0.5% lidocaine and 0.5 ug/kg dexmedetomidine. We investigated onset and duration of sensory and motor blocks, the quality of the anaesthesia, intraoperative - postoperative heamodynamic, pain and sedation. We found that the addition of dexmedetomidine or tramadol modify the action of local anaesthetic, providing a shorter onset time of sensory block and less tourniquet pain in IVRA but dexmedetomidine more better because faster and less incidence of side effect