Comparative study between Fentanyl with (Lidocaine and Bupivicaine) Versus (Lidocaine and Bupivicaine) alone in Supraclavicular Brachial Plexus Block in Upper Limb Surgeries
Abstract Background Post operative pain and stress is a very known complication of many surgical procedures which represents a burden for the patient and associated with many complications including stress, myocardial ischemia, prolonged hospital stay and the need of extensive post operative analgesia. Aim of the Work to study the effect of Fentanyl as an adjuvant to bupivacaine and Lidocaine in supraclavicular brachial plexus block. After taking approval from Local Ethical Committee approval and informed written consent from each patient, this randomized prospective comparative study was conducted on 60 patients who were divided into two groups: Group A (Control group): 20 ml of 0.5% bupivacaine + 6 ml of lidocaine hydrochloride 2% + 1 ml of Normal Saline 0.9%. Group B (Fentanyl group): 20 ml of 0.5% bupivacaine + 6 ml of lidocaine hydrochloride 2% + 1ml of fentanyl 50 ug/ml. Results our study showed that addition of a 50 microgram of fentanyl to bupivacaine and lidocaine in ultrasound-guided supraclavicular nerve block has statistically significant effect on the onset of sensory and motor block and prolonged the duration of the sensory and the motor block. In addition, fentanyl prolonged the duration of analgesia of the plexus block significantly, as proved by the time of request of first analgesia. Moreover, in fentanyl group, postoperative analgesic requirements were greatly lesser than that of bupivacaine and lidocaine groups. Addition of fentanyl also did not affect the hemodynamic to a significant level Conclusion fentanyl with bupivacaine and lidocaine more superior than the use of bupivacaine and lidocaine alone.