scholarly journals Comparison of Postoperative Analgesic Effect of Dexamethasone and Fentanyl Added to Lidocaine through Axillary Block in Forearm Fracture

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Siamak Yaghoobi ◽  
Mahyar Seddighi ◽  
Zohreh Yazdi ◽  
Razieh Ghafouri ◽  
Marzieh Beigom Khezri
Keyword(s):  
Analgesic Effect ◽  
Motor Block ◽  
Forearm Fracture ◽  
Onset Time ◽  
Analgesic Efficacy ◽  
Controlled Study ◽  
Axillary Block ◽  
Regional Analgesia ◽  
Double Blind ◽  
Hemodynamic Variables

Aim. Regional analgesia has been introduced as better analgesic technique compared to using systemic analgesic agents, and it may decrease the adverse effects of them and increase the degree of satisfaction. Several additives have been suggested to enhance analgesic effect of local anesthetic agents such as opioids and steroids. We designed this randomized double-blind controlled study to compare the analgesic efficacy of the dexamethasone and fentanyl added to lidocaine using axillary block in patients undergoing operation of forearm fracture. Materials and Methods. Seventy-eight patients 20–60 years old were recruited in a prospective, double-blinded, randomized way. Axillary block was performed in the three groups by using 40 mL lidocaine and 2 mL distilled water (L group), 40 mL lidocaine and 2 mL dexamethasone (LD group), and 40 mL lidocaine and 2 mL fentanyl (LF group). The onset time of sensory and motor block, duration of sensory and motor block, the total analgesic dose administered during 6 hours after the surgery, and hemodynamic variables were recorded. Results. The duration of sensory and motor block was significantly longer in LD group compared to other groups (P<0.001). Similarly, the total analgesic consumption in LD group was smaller compared to other groups (P<0.001). Comparison of hemodynamic consequences of axillary block and surgery failed to reveal any statistically significant differences between all groups. Conclusion. Addition of dexamethasone to lidocaine significantly prolonged the duration of analgesia compared with fentanyl/lidocaine mixture or lidocaine alone using axillary block in patients undergoing forearm fracture surgery. This trial is registered with IRCT2012120711687N1.

scholarly journals Does the Use of Nitroglycerin Patch Improve Local Anaesthetic Effects in Bier’s Block? A Double-Blind Placebo Controlled Study

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Ahmed Said Elgebaly
Keyword(s):  
Analgesic Effect ◽  
Recovery Time ◽  
Motor Block ◽  
Onset Time ◽  
Sensory Block ◽  
Controlled Study ◽  
Patients Satisfaction ◽  
Recovery Times ◽  
Vas Scores ◽  
Motor Effects

Aim. The aim of the study was to assess the nitroglycerin patch as a new additive to Bier’s block and its impact on the effects and dose of lidocaine. Methods. Forty patients of each sex belonging to ASA I or II underwent elective tendon repair surgeries of the forearm and hand. The patients were divided into two equal groups as follows: Group C received only lidocaine (1.5 mg/kg, 0.25%) and Group N received lidocaine (1.5 mg/kg, 0.25%) + 5 mg transcutaneous nitroglycerin patch. Onset and recovery times for sensory and motor block, visual analogue scale (VAS) scores for bandage pain, postoperative VAS score, analgesic requirements, patients’ satisfaction, and surgeons’ opinion were recorded. Results. Sensory block onset time was shorter in Group N (3.80 ± 1.0) than that in Group C (5.72 ± 1.46), and motor block onset time was shorter in Group N (10.72 ± 1.93) than that in Group C (13.56 ± 1.26). Sensory block recovery time was prolonged in Group N (10.56 ± 1.12) than Group C (6.88 ± 1.45), recovery time of motor block was prolonged in Group N (13.04 ± 1.57) than Group C (11.96 ± 1.72). Bandage pain had lower VAS scores in Group N. Postoperative VAS scores showed significant differences between both groups at the following points of measurement: 30 minutes, 1 hour, and 4 hours after bandage deflation. Postoperative analgesic effect was the longest in Group N (187.20 ± 60.79 min) than Group C (51.60 ± 25.28 min). Patients’ satisfaction and surgeons’ opinion were better in Group N than Group C. Conclusion. Supplementation of Bier’s block with transcutaneous nitroglycerin patch reduces the lidocaine dose, the sensory and motor block onset times, VAS scores, and analgesic consumption intra- and postoperatively. Length of the block recovery times for the sensory and motor effects, duration of postoperative analgesic effect, and the first time to analgesic requirement improved the quality of Bier’s block with better patients’ satisfaction and surgeons’ opinion and had no adverse effects.

scholarly journals The Effect of Dexmedetomidine in Combination with Bupivacaine on Sensory and Motor Block Time and Pain Score in Supraclavicular Block

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Shahryar Sane ◽  
Shahram Shokouhi ◽  
Parang Golabi ◽  
Mona Rezaeian ◽  
Behzad Kazemi Haki
Keyword(s):  
Postoperative Pain ◽  
Pain Score ◽  
Upper Extremity ◽  
Motor Block ◽  
Intervention Group ◽  
Onset Time ◽  
Double Blind ◽  
Old Patients ◽  
Arterial Blood ◽  
Supraclavicular Block

Background. Brachial plexus block is frequently recommended for upper limb surgeries. Many drugs have been used as adjuvants to prolong the duration of the block. This study aimed to assess the effect of dexmedetomidine with bupivacaine combination and only bupivacaine on sensory and motor block duration time, pain score, and hemodynamic variations in the supraclavicular block in upper extremity orthopedic surgery. Methods. This prospective, double-blind clinical trial study was conducted on 60 patients, 20 to 60 years old. Patients were candidates for upper extremity orthopedic surgeries. The sensory and motor block were evaluated by using the pinprick method and the modified Bromage scale. The postoperative pain was assessed by utilizing a visual analog scale. Results. The mean onset time of sensory and motor block in patients receiving only bupivacaine was, respectively, 31.03 ± 9.65 min and 24.66 ± 9.2 min, and in the dexmedetomidine receiving group, it was about 21.36 ± 8.34 min and 15.93 ± 6.36 minutes. The changes in heart rate and mean arterial blood pressure were similar in both groups. The duration of sensory and motor block and the time of the first analgesia request in the intervention group were longer. Postoperative pain was lower in the intervention group for 24 hours ( P  = 0.001). Conclusion. Dexmedetomidine plus bupivacaine reduced the onset time of sense and motor blocks and increased numbness and immobility duration. Also, dexmedetomidine reduced postoperative pain significantly with the use of bupivacaine for supraclavicular blocks. Trial Registration. IRCT, IRCT20160430027677N15. Registered 05/28/2019, https://www.irct.ir/trial/39463.

scholarly journals Comparison of 0.5% Ropivacaine and 0.5% Bupivacaine in Lumbar Epidural Anaesthesia for Lower Limb Orthopaedic Surgery

1997 ◽  
Vol 25 (3) ◽  
pp. 262-266 ◽  
Author(s):  
D. P. McGlade ◽  
M. V. Kalpokas ◽  
P. H. Mooney ◽  
M. R. Buckland ◽  
S. K. Vallipuram ◽  
...  
Keyword(s):  
Lower Limb ◽  
Orthopaedic Surgery ◽  
Motor Block ◽  
Onset Time ◽  
Sensory Block ◽  
Pressure Profile ◽  
Technical Failure ◽  
Time Duration ◽  
Double Blind ◽  
Multi Centre Study

The purpose of this study was to compare the epidural use of 0.5% ropivacaine and 0.5% bupivacaine in patients undergoing lower limb orthopaedic surgery. In a double-blind, randomized, multi-centre study involving 67 patients, thirty-two patients received 20 ml of 0.5% ropivacaine and 35 patients received 20 ml of 0.5% bupivacaine at the L2,3 or L3,4 interspace. Parameters measured were the onset time, duration and spread of sensory block, the onset time, duration and degree of motor block, the quality of anaesthesia and the heart rate and blood pressure profile during block onset. Four patients (3 ropivacaine, 1 bupivacaine) were excluded from the study due to technical failure of the block. The onset and duration of analgesia at the T10 dermatome (median, interquartile range) was 10 (5-15) minutes and 3.5 (2.7-4.3) hours respectively for ropivacaine, and was 10 (6-15) minutes and 3.4 (2.5-3.8) hours respectively for bupivacaine. Maximum block height (median, range) was T6 (T2-T12) for ropivacaine and T6 (C7-T10) for bupivacaine. Nine patients receiving ropivacaine and eight patients receiving bupivacaine developed no apparent motor block. The incidence of complete motor block (Bromage grade 3) was low in both groups, being 4/27 for ropivacaine and 6/34 for bupivacaine. In the ropivacaine group, motor and sensory block were judged to be satisfactory in 78% of patients. In the bupivacaine group, motor and sensory block were judged to be satisfactory in 71% and 62% of patients respectively. Cardiovascular changes were similar in both groups. No statistical differences were found between the two groups regarding any of the study parameters.

Etoricoxib Provides Analgesic Efficacy to Patients After Knee or Hip Replacement Surgery: A Randomized, Double-Blind, Placebo-Controlled Study

2005 ◽  
Vol 101 (4) ◽  
pp. 1104-1111 ◽  
Author(s):  
G Lynn Rasmussen ◽  
Kerstin Malmstrom ◽  
Michael H. Bourne ◽  
Maurice Jove ◽  
Steven M. Rhondeau ◽  
...  
Keyword(s):  
Hip Replacement ◽  
Analgesic Efficacy ◽  
Controlled Study ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Replacement Surgery ◽  
Hip Replacement Surgery

scholarly journals COMPARISON OF INTUBATING CONDITIONS BETWEEN ATRACURIUM PRIMING, MAGNESIUM SULPHATE PRE-TREATMENT AND COMBINATION OF TWO METHODS ON ONSET AND DURATION OF NEUROMUSCULAR BLOCKADE: A RANDOMIZED DOUBLE BLIND CONTROLLED STUDY

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Kushal Jethani ◽  
Preeti Sahu ◽  
Rakesh D R
Keyword(s):  
General Anaesthesia ◽  
Neuromuscular Blockade ◽  
Magnesium Sulphate ◽  
Onset Time ◽  
Neuromuscular Relaxants ◽  
Controlled Study ◽  
Double Blind ◽  
Elective Surgical Procedures ◽  
Motor End Plate ◽  
Pre Treatment

Introduction: Magnesium inhibits acetylcholine release from the presynaptic membrane at the motor end plate; and thus it enhances the effect of non-depolarising muscle relaxants. Priming technique shortens the time of onset of non depolarising neuromuscular relaxants. Thus, the combination of magnesium pre-treatment and priming may be an effective method for achieving an early tracheal intubating condition. We studied the effect of magnesium sulphate pretreatment in combination with atracurium priming on onset and duration of neuromuscular blockade, compared with these methods when used alone. Materials and Methods: 100 patients scheduled for elective surgical procedures under general anaesthesia were divided into 4 groups. Group A (n=25) recieved priming with 0.05 mg/kg atracurium, three minutes before the intubating dose of atracurium 0.5 mg/kg, group M (n=25) was given 50 mg/kg magnesium sulphate as infusion over 10 mins before intubating dose of atracurium, group MA (n=25) received both the magnesium sulphate pretreatment and the priming dose of atracurium. Group N (n = 25) were given 0.5mg/kg atracurium alone as part of general anaesthesia. Tracheal intubation was done when the TOF stimulation showed single twitch which was measured at intervals of every 30 seconds. Parameters studied were the time to onset of neuromuscular blockade and the duration of neuromuscular blockade. Results: The MA group had the shortest onset time (mean±SD) 114.30±20.19 sec (p < 0.001) compared to the other groups. The duration of blockade was prolonged in both Group MA and Group M compared to other groups (P<0.001). Few adverse effects were reported in groups receiving magnesium, but were clinically not significant. Conclusion: Magnesium sulphate pretreatment in combination with atracurium priming shortens the time of onset of neuromuscular blockade when compared to magnesium sulphate pretreatment or priming used alone. Keywords: Atracurium priming, magnesium sulphate, neuromuscular blockade

scholarly journals A Comparison of 0.5% Ropivacaine and 0.5% Bupivacaine for Axillary Brachial Plexus Anaesthesia

1998 ◽  
Vol 26 (5) ◽  
pp. 515-520 ◽  
Author(s):  
D. P. McGlade ◽  
M. V. Kalpokas ◽  
P. H. Mooney ◽  
D. Chamley ◽  
A. H. Mark ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Median Duration ◽  
Motor Block ◽  
Brachial Plexus Block ◽  
Onset Time ◽  
Local Anaesthetics ◽  
Double Blind ◽  
Peripheral Nerve Stimulator ◽  
Upper Limb Surgery ◽  
Plexus Block

The purpose of this study was to compare the use of 0.5% ropivacaine with 0.5% bupivacaine for axillary brachial plexus anaesthesia. Sixty-six patients undergoing upper limb surgery were enrolled in a double-blind, randomized, multicentre trial. Five patients were subsequently excluded for various reasons. Of the remaining patients, 30 received 40 ml of 0.5%) ropivacaine and 31 received 40 ml of 0.5% bupivacaine. Brachial plexus block was performed by the axillary approach using a standardized technique with a peripheral nerve stimulator. Parameters investigated included the frequency, onset and duration of sensory and motor block, the quality of anaesthesia and the occurrence of any adverse events. The six principal nerves of the brachial plexus were studied individually. The frequency for achieving anaesthesia per nerve ranged from 70 to 90% in the ropivacaine group and 81 to 87% in the bupivacaine group. The median onset time for anaesthesia was 10 to 20 minutes with ropivacaine and 10 to 30 minutes with bupivacaine, and the median duration was 5.3 to 8.7h with ropivacaine and 6.9 to 20.3h with bupivacaine. Motor block was evaluated at the elbow, wrist and hand, and was completely achieved at a rate of 60 to 73% in the ropivacaine group and 55 to 71% in the bupivacaine group. The median duration of motor block was 6.5 to 7.5h with ropivacaine and 6.0 to 9.0h with bupivacaine. These parameters were not statistically different. The duration of partial motor block at the wrist (6.8 v 16.4h) and hand (6.7 v 12.3h) was significantly longer with bupivacaine. Ropivacaine 0.5% and bupivacaine 0.5%) appeared equally efficacious as long-acting local anaesthetics for axillary brachial plexus block.

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