scholarly journals Global Joint Entropy Algorithm-Based Evaluation of Dexmedetomidine Combined Local Anesthetics in Brachial Plexus Block from Ultrasound Images

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Xiujuan Ge ◽  
Xiaopeng Song ◽  
Linyan Li
Keyword(s):  
Postoperative Pain ◽  
Brachial Plexus ◽  
Local Anesthetics ◽  
Brachial Plexus Block ◽  
Motor Nerve ◽  
Joint Entropy ◽  
Upper Limb Surgery ◽  
Group A ◽  
Group B ◽  
Plexus Block

This paper aimed to explore dexmedetomidine combined local anesthetics in brachial plexus block through ultrasound imaging (UI) under global joint entropy algorithm. Patients who underwent upper limb surgery and brachial plexus block were selected as research objects. Patients in group A were given 0.375% ropivacaine and normal saline, and patients in group B were given 0.375% ropivacaine and 1.0 μg/kg dexmedetomidine. The results of UI were analyzed by global joint entropy-based K-means clustering (GKC) algorithm, and the use effects of the two methods were compared in combination with other postanesthesia manifestations. The results were as follows. The segmentation accuracy (96.21% and 83.52%) of GKC was higher than 82.21% and 70.52% of the local joint entropy-based K-means clustering (LKC) ( P < 0.05 ). The duration of sensory and motor block (352.78 ± 45.89 min and 324.38 ± 41.29 min) in group B was significantly longer than 292.28 ± 35.69 min and 256.58 ± 42.76 min in group A ( P < 0.05 ). Compared with 84.91 ± 8.77 beats/min and 89.58 ± 7.62 beats/min in group A, mean arterial pressure (70.24 ± 9.77 beats/min and 69.89 ± 8.97 beats/min) in group B was lower at T1 and T2 ( P < 0.05 ). The duration of postoperative pain (582.70 ± 51.89 min) in group B was longer than 372.89 ± 49.89 min in group A ( P < 0.05 ). The postoperative pain score (2.98 ± 1.08) in group B was significantly lower than 4.48 ± 2.19 in group A ( P < 0.05 ). Therefore, dexmedetomidine combined local anesthetics could prolong the duration of sensory and motor nerve block. Besides, dexmedetomidine had sedative and analgesic effects, so as to prolong postoperative pain time and reduce pain degree of patients.

scholarly journals A Comparative Clinical Study of Levobupivacaine and Levobupivacaine with Dexmedetomidine for Supraclavicular Brachial Plexus Block

2021 ◽  
Vol 8 (13) ◽  
pp. 760-763
Author(s):  
Sabir Hasnat ◽  
Sohail Ahmad ◽  
Ashutosh Kumar Jha
Keyword(s):  
Brachial Plexus ◽  
Brachial Plexus Block ◽  
Motor Blockade ◽  
Duration Of Action ◽  
Upper Limb Surgery ◽  
Prolonged Duration ◽  
Supraclavicular Brachial Plexus Block ◽  
Group A ◽  
Group B ◽  
Plexus Block

BACKGROUND Sensory and motor functions of peripheral nerve can be blocked by injecting local anaesthetic around the group of nerves, which will stop the conduction of nerve impulse. Peripheral nerve block is a well-accepted technique in anaesthesia care. Brachial plexus block is also one of the reliable techniques in providing regional anaesthesia for upper limb surgery. METHODS This was a prospective, double blinded, randomised comparative study which included 40 patients of American Society of Anaesthesiologists (ASA) grade I and II of either sex of 20 - 65 years old age groups for upper limb surgery. Cases were divided randomly into two groups: Group A: received levobupivacaine hydrochloride 0.5 % 25 cc with dexmedetomidine injection. Group B: received levobupivacaine hydrochloride 0.5 % 25 cc injection. Each individual was allocated to respective group by computer generated randomisation chart. Both group A and B were assessed for the onset of sensory & motor block, duration of postoperative analgesia and duration of action. RESULTS In the present study, it was observed that the onset of sensory blockade (P < 0.001) & motor blockade (P < 0.001) was earlier in groups A with prolonged duration of sensory & motor blockade (P < 0.001) as compared to group B. Group A took longer time for first rescue analgesia post operatively compared to group B, and the difference was found significant (P < 0.001). Both group A and group B were comparable for systolic blood pressure, diastolic blood pressure, and heart rate. CONCLUSIONS The onset of sensory and motor blockade was early in 0.5 % levobupivacaine with dexmedetomidine with prolonged duration of action and required lesser dose of rescue analgesic in 0.5 % levobupivacaine with dexmedetomidine as compared to 0.5 % levobupivacaine in supraclavicular brachial plexus block. KEYWORDS Dexmedetomidine, Levobupivacaine, Brachial Plexus Block

scholarly journals Addition of clonidine or fentanyl with bupivacaine for supraclavicular brachial plexus blocks in upper limb surgery - a randomized comparative study

2014 ◽  
Vol 24 (1) ◽  
pp. 3-7
Author(s):  
Nasir Uddin Ahmed ◽  
Mozaffor Hossain ◽  
AKM Akhtaruzzaman ◽  
Montosh Kumar Mondol ◽  
UH Shahera Khatun
Keyword(s):  
Brachial Plexus ◽  
Brachial Plexus Block ◽  
Sensory Block ◽  
Control Group ◽  
Upper Limb Surgery ◽  
Supraclavicular Brachial Plexus Block ◽  
Group A ◽  
Group B ◽  
Plexus Block

Background The popularity of supraclavicular brachial plexus block in upper limb surgery in recent years are due to better understanding of using adjuvant to local anaesthetics, its advantages and in avoidance of the hazards of general anaesthesia. Objective To compare the quality of anaesthesia and duration of analgesia with clonidine-bupivacaine or fentanyl-bupivacaine in supraclavicular brachial plexus block. Method A total number of 60 patients (ASA class 1 and II) were selected randomly into two groups, thirty in each group. Group-A (control group) received fentanyl (100ìg) 2ml and bupivacaine (0.25%) 38ml, total of 40ml.Group-B (study group) received clonidine (150ìg) 2ml and bupivacaine (0.25%) 38ml, total of 40ml.The parameters including pulse rate, non-invasive systolic and diastolic blood pressure, respiratory rate, SpO2, onset and duration of motor and sensory block, post operative pain score in VAS, duration of analgesia, first analgesic demand, side effects were assessed and recorded. Result Onset and duration of sensory block were significantly higher in group-B than in group-A (P<0.001) and motor block were quite prolonged in group-B than group-A (p<0.001), prevalence of sedation in group-B slightly higher than group-A. But intensity of pain measured by VAS in group-A expressed highest at 8 hours of postoperative period and group-B shows highest VAS at 12 hours. Duration of effective analgesia (time from supraclavicular block to first analgesic demand) in study group-B had significantly longer mean duration than that produced by control group-A (14.4 ± 1.3 vs 10.9 ± 1.5 hours; P<0.001). Conclusion Clonidine and bupivacaine combination is a better alternative to fentanyl and bupivacaine in respect of quality of anaesthesia and duration of analgesia. DOI: http://dx.doi.org/10.3329/jbsa.v24i1.19792 Journal of Bangladesh Society of Anaesthesiologists 2011; 24(1): 3-7

scholarly journals A comparative study between the effect of verapamil versus nalbuphine as an adjuvant in supraclavicular brachial plexus block

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Mohammed Ibrahim Khamis ◽  
Ahmed Saeed Mohamed ◽  
Hesham Mohamed El Azazy ◽  
Hala Salah El Ozairy ◽  
Mohamed Moien Mohamed
Keyword(s):  
Comparative Study ◽  
Brachial Plexus ◽  
Normal Saline ◽  
Motor Block ◽  
Brachial Plexus Block ◽  
Sensory Block ◽  
Motor Blockade ◽  
Group A ◽  
Group B ◽  
Plexus Block

Abstract Background Brachial plexus block has substituted general anesthesia in the majority of patients planned for upper limb surgeries as it avoids the undesired effects of the medications used in general anesthesia as well as the stress response associated with airway manipulation. Opioid agonist–antagonists such as nalbuphine are used as adjuvant to improve the anesthetic properties of bupivacaine. Verapamil has an additive effect in brachial plexus blockade in the form of decreasing the consumption of analgesics in the postoperative period with reducing onset time and extending the duration of motor and sensory blockade. The aim of this study is to investigate the adjuvant effect of verapamil versus nalbuphine to 0.5% bupivacaine in brachial plexus block as regards onset, duration of sensory and motor blockade and postoperative analgesic augmentation. The study is randomized, prospective, double-blinded, comparative study where 90 patients subjected to arm, forearm and hand surgeries were randomized into three groups, group A received 30 ml of plain bupivacaine 0.5% plus 2 ml of normal saline, group B received 30 ml of bupivacaine 0.5% plus 2 ml verapamil equivalent to 5 mg, group C received 30 ml of bupivacaine 0.5% plus 10 mg of nalbuphine diluted in 2 ml of normal saline. Results Results of this study showed that group C and group B sensory block time onset was 7.25 ± 1.5 vs. 10.92 ± 3.84 min, P < 0.001 and was shorter than that in group A (13.2 ± 2.66 min). In addition, the motor block onset was (11.10 ± 1.24 vs. 13.50 ± 3.77 min, P < 0.001) shorter than group A (17.16 ± 1.30 min). In group C and group B, sensory block duration was 396 ± 32.17 vs. 355.83 ± 18.48 min, P < 0.001, respectively and was longer than that in group A (321.13 ± 25.08 min). Also, there was prolonged motor block duration in group C and group B recording (338.92 ± 25.2 vs. 302.93 ± 15.24 min, P < 0.001) and was longer than that in group A (280.70 ± 32.35 min). Time of demand of rescue analgesia dose was significantly long in group C and group B (449.53 ± 52.45 vs. 418.13 ± 41.12 min, P < 0.001) and was longer than group A (361.31 ± 21.42 min). Both verapamil and nalbuphine have additive effect to bupivacaine improving the all anesthetic parameters of the block. Conclusion Both drugs produce favorable enhancement of time onset and effective prolongation of duration of sensory and motor blockade and extend the period of postoperative analgesia with superiority to nalbuphine over verapamil.

Dexamethasone as an Adjuvant to 0.5 % Ropivacaine for Ultrasound Guided Supraclavicular Brachial Plexus Block

2021 ◽  
Vol 8 (14) ◽  
pp. 849-853
Author(s):  
Shweta Saurin Mehta ◽  
Nidhiben Sureshbhai Patel
Keyword(s):  
Adverse Effects ◽  
Brachial Plexus ◽  
Upper Limb ◽  
Brachial Plexus Block ◽  
Supraclavicular Approach ◽  
Supraclavicular Brachial Plexus Block ◽  
Group A ◽  
Group B ◽  
Regional Anaesthetic Technique ◽  
Plexus Block

BACKGROUND Supraclavicular brachial plexus block is a reliable, regional anaesthetic technique for upper limb surgeries. Also known as “spinal of upper limb”.1 The present study was conducted to assess the analgesic efficacy of dexamethasone as an adjuvant to 0.5 % ropivacaine for ultrasound sonography (USG) guided brachial plexus block. METHODS 50 adult patients of American Society of Anaesthesiologists (ASA) physical status I and II of both genders, aged 18 - 50 years scheduled for elective upper limb surgeries under brachial plexus block via supraclavicular approach were randomised into 2 groups of 25 patients each to receive either 20 ml of 0.5 % ropivacaine with 2 ml of normal saline (group A) or 20 ml of 0.5 % ropivacaine with 2 ml of dexamethasone (8 mg) (group B). RESULTS Use of ultrasound helps in better visualisation of nerves, needle & spread of local anaesthetic at brachial plexus block site. So, less amount of drug volume is required for the block. Time of onset of sensory and motor block was significantly lower in group B compared to group A. Mean duration of motor and sensory block was significantly longer in group B than group A. The duration of postoperative analgesia was 18.79 ± 2.31 hours in group B & 9.06 ± 0.35 hours in group A, with statistically highly significant difference (P < 0.05). There were no perioperative haemodynamic variations between the two groups and no complication of technique or adverse effects due to dexamethasone occurred. CONCLUSIONS Dexamethasone 8 mg has significantly extended duration of analgesia of brachial plexus block with no adverse effects. KEYWORDS Brachial Plexus Block, Ropivacaine, Dexamethasone, Supraclavicular Approach, Ultrasound Guidance

scholarly journals Tramadol as an adjunct to bupivacaine for brachial plexus block.

2019 ◽  
Vol 26 (09) ◽  
pp. 1482-1486
Author(s):  
Afifa Zahoor ◽  
Ranna Mussrat ◽  
Muhammad Ahmad Khan ◽  
Shakeel Ahmad
Keyword(s):  
Brachial Plexus ◽  
Brachial Plexus Block ◽  
University Hospital ◽  
Orthopedic Procedures ◽  
Controlled Study ◽  
P Value ◽  
Rescue Analgesia ◽  
Group A ◽  
Group B ◽  
Plexus Block

Objectives: To compare the efficacy of tramadol and 0.25% bupivacaine versus 0.25% bupivacaine alone for brachial plexus block. Study Design: Randomized controlled study. Setting: Orthopedic department of Nishtar Medical University/Hospital Multan. Period: The study duration was Jan-2018 to Aug-2018. Material and Methods: 148 patients planned for with upper limb orthopedic procedures under BPB in the department of orthopedics department Nishtar Hospital Multan were included in this analysis. To Patients were randomly divided into two equal groups by lottery method. Group A patients were given solution with 38 ml 0.25% bupivacaine with 100 mg tramadol 2 ml and group B were given solution with 38 ml 0.25% bupivacaine and 2 ml 0.9 % normal saline. Time of onset of block and its duration and need for rescue analgesics were noted. Results: Time of onset of block was 14.56+1.01 minutes in group A versus 15.96+1.64 minutes in group B (p-value <0.001). Mean analgesia duration was 355.85+42.18 minutes in group A versus 310.47+38.79 minutes in group B (p-value <0.001). There were 51 (68.9%) patients in group A who required rescue analgesia and 68 (91.9%) patients in group B required rescue analgesia (p-value 0.004). Conclusion: We concluded that the addition of tramadol as adjunct to bupivacaine for BPB significantly shortens the duration of onset, prolongs the duration of analgesia and reduces the need for rescue analgesics.

scholarly journals Effect of Addition of Dexamethasone to Local Anaesthetics in Supraclavicular Brachial Plexus Block

1970 ◽  
Vol 7 (1) ◽  
pp. 11-14 ◽  
Author(s):  
SM Islam ◽  
MHMD Hossain ◽  
AA Maruf
Keyword(s):  
Brachial Plexus ◽  
Motor Block ◽  
Brachial Plexus Block ◽  
Onset Time ◽  
Local Anaesthetics ◽  
Prolonged Duration ◽  
Supraclavicular Brachial Plexus Block ◽  
Group A ◽  
Group B ◽  
Plexus Block

Introduction: Many-a-time local anaesthesia appears as a very effective alternative of general one. Different additives have been used to prolong regional blockade. Objective: This prospective study designed to evaluate the effect of dexamethasone added to local anaesthetics on the onset and duration of supraclavicular brachial plexus block. Methods: Sixty adult patients undergoing various orthopaedic surgeries on forearm and around the elbow under supraclavicular brachial plexus block were selected and divided into 2 groups of 30 each. In group-A patients received 35 ml of mixture of lignocaine 2%, bupivacaine 0.5% while in group-B patients received the same amount of local anaesthetics with dexamethasone (8 mg). The onset of sensory and motor block and duration of analgesia in two groups were compared and development of complications were observed. Result: The two groups were comparable in demographic data. The mean onset time of sensory block was 11.64±2.19 minutes in group A and 9.89±1.97 minutes in group B and difference was statistically significant (p<0.05). Onset of motor block was 13.32±0.98 minutes in group A and 11.09±1.28 minutes in group B and difference was statistically significant (p<0.05). There was markedly prolonged duration of analgesia in group-B, 11.87± 0.53 hours compared to group-A, 3.43±0.49 hours. The result was statistically highly significant (p<0.001). Both the groups had high success rate (>90%). The incidence of complication was low in both the groups. Conclusion: Addition of dexamethasone as an adjuvant to local anaesthetics in brachial plexus block results in significantly early onset and markedly prolonged duration of analgesia without any unwanted effects. Key words: Supraclavicular block; analgesia; local anaesthetics; dexamethasone DOI: http://dx.doi.org/10.3329/jafmc.v7i1.8619 JAFMC Bangladesh. Vol 7, No 1 (June) 2011; 11-14

scholarly journals Addition of 100 mg of Tramadol to 40 mL of 0.5% Ropivacaine for Interscalene Brachial Plexus Block Improves Postoperative Analgesia in Patients Undergoing Shoulder Surgeries as Compared to Ropivacaine Alone—A Randomized Controlled Study

Medicina ◽  
2019 ◽  
Vol 55 (7) ◽  
pp. 399 ◽  
Author(s):  
Eleftheria Soulioti ◽  
Athanasia Tsaroucha ◽  
Alexandros Makris ◽  
Maria Koutsaki ◽  
Eirini Sklika ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Motor Block ◽  
Brachial Plexus Block ◽  
Sensory Block ◽  
Shoulder Surgery ◽  
Morphine Consumption ◽  
Interscalene Brachial Plexus Block ◽  
Group A ◽  
Group B ◽  
Plexus Block

Background and objectives: Brachial plexus block is commonly used in shoulder surgery, as it provides satisfactory surgical conditions and adequate postoperative pain control. However, there are contradictory reports regarding the addition of tramadol to the injected regional anesthetic solution. We performed a prospective randomized study to evaluate the effectiveness of tramadol as an adjuvant to ropivacaine during interscalene brachial plexus block and assess its impact on the opioid consumption and the early postoperative pain in patients that underwent shoulder surgery. Materials and Methods: Eighty patients scheduled for elective shoulder surgery and anesthesia via interscalene brachial plexus block were randomly divided into two groups. In group A (n = 40), a solution of 40 mL of ropivacaine 0.5% and 2 mL (100 mg) of tramadol was administered during the brachial plexus block, while in group B (n = 40), a solution of 40 mL of ropivacaine 0.5% and 2 mL NaCl 0.9% (placebo) was administered. The effectiveness and duration of sensory and motor blocks were recorded in both groups. The sensory block was assessed recording the loss of sensation to pin prick test over the skin distribution of the axillary, radial, and musculocutaneous nerves. The motor block was assessed using the modified 3-point Bromage score (0–2 points). Cumulative morphine consumption and pain, using the Visual Analog Scale (VAS), were evaluated in both groups at 2, 4, 8, and 24 h after surgery. Results: Sensory block onset was achieved earlier in group A than in group B (5.21 ± 3.15 minutes (min) vs. 7.1 ± 4.51 min, p = 0.029). The motor block onset was similar between the two groups (13.08 ± 6.23 min vs. 13.28 ± 6.59 min; p = 0.932). The duration of the sensory block was longer in group A as compared to group B (13 ± 2.3 h vs. 12 ± 2.8 h; p = 0.013). The duration of the motor block did not present any difference between the groups (10 ± 2.2 h vs. 10 ± 2.8 h; p = 0.308). Differences in morphine administration were not significant at 2, 4, and 8 h, however, morphine consumption was found to be decreased in group A 24 h postoperatively A (p = 0.04). The values of VAS were similar at 2, 4, and 8 h, however, they were lower in group A at 24 h (p < 0.013). Conclusions: Combined regional administration of tramadol and ropivacaine during interscalene brachial plexus block improves the time of onset and the duration of the sensory block, while it is associated with reduced morphine consumption during the first 24 h after shoulder surgery.

scholarly journals Anaesthetic and analgesic eects of adding fentanyl to bupivacaine-lignocaine mixtures in supraclavicular brachial plexus block – a comparative study with or without fentanyl

2016 ◽  
Vol 44 (1) ◽  
pp. 26-31
Author(s):  
Farhanaz Zainab ◽  
Mohammad Omar Faruq ◽  
Moumita Talukder ◽  
Sabina Yeasmeen ◽  
AKM Shamsul Alam ◽  
...  
Keyword(s):  
Comparative Study ◽  
Brachial Plexus ◽  
Motor Block ◽  
Brachial Plexus Block ◽  
Onset Time ◽  
Supraclavicular Brachial Plexus Block ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Plexus Block

Brachial plexus block is gaining popularity day by day for upper extremity surgery because it has manifold advantages. Supraclavicular approach offers a high success rate for elbow, forearm, hand surgery. Different mixtures of local anesthetics are intended to provide faster block onset than long-acting agents and to extend the duration typically seen with intermediate or short-acting agents. This prospective, randomized comparative study was conducted to compare the onset time of sensory block, onset time of motor block and time to achieve complete block, duration of analgesia adding fentanyl with bupivacaine-lignocaine mixtures in supraclavicular brachial plexus block. A total of 60 patients fulfilling the inclusion and exclusion criteria were selected for the study & devided into two groups. Group A received lignocaine-bupivacaine mixtures( 1% lignocaine, 0.25% bupivacaine) and was considered control; group Group B received fentanyl (100?g) with the local anaesthetic mixtures( 1% lignocaine, 0.25% bupivacaine). The mean onset of sensory and motor block were significantly early in group B compared with that of group A. The mean time to achieve complete block and duration of analgesia were significantly longer in group B. It was revealed in the study that patients of group B had no pain up to 4 hrs, there was first reporting of pain (VAS >4) around 5 hrs, the worst pain was experienced after 8 hrs, first dose of analgesic was administered according to patient’s request. The patients of group A had no pain up to 3 hrs. Thereafter pain intensity increased at 4 hrs, around 6 hrs postoperatively the patients experienced the worst pain . This feature reveals a significantly longer duration of analgesia in group B. This study revealed that addition of fentanyl significantly causes early onset of anaesthesia and longer duration of analgesia without any side effects.Bangladesh Med J. 2015 Jan; 44 (1): 26-31

scholarly journals Effect of Verapamil Adjuvant with Local Anaesthetic Mixtures in Supraclavicular Brachial Plexus Block

2019 ◽  
Vol 46 (2) ◽  
pp. 43-47
Author(s):  
Md Arman Ali ◽  
Md Latifur Rahman ◽  
Mehdi Hassan ◽  
Rezwanur Rahman ◽  
Kai Nur Asfia ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Brachial Plexus Block ◽  
Randomized Study ◽  
Onset Time ◽  
Sensory Block ◽  
Local Anaesthetics ◽  
P Value ◽  
Group A ◽  
Group B ◽  
Plexus Block

Among the various approaches to block brachial plexus , supraclavicular approach offers a high success rate for elbow, forearm and hand surgery . Various adjuvant drugs have been used with local anesthetics in order to decrease the time of onset and prolong the duration and quality of regional blocks. So efforts were made to combine the adjuvant with local anesthetics to improve patient and surgeon satisfaction. In this randomized study we tried to see the effect of verapamil in brachial plexus block as an adjuvant with local anaesthetic .This randomized study wasconducted in Anaesthesiology department of ShaheedZiaurRahman Medical College Hospital after approved by the ethical review board of this hospital.The study subject were divided into two groups (Group A=only local anaesthetics&Group B=local anaesthetics with Verapamil) , 30 IN numbers in each group. Group-A patients was administered 15ml of 1% lignocaine with 15 ml of bupivacaine 0.25% while in Group-B patients was administered injection verapamil 3.5 ml (3.5 mg) in addition to the above mixture. In this study mean onset time of sensory block was 11.53 ± 1.4 minutes in group - A and 7.12 ± 1.68 minutes in group – B which is not statistically significant (p value = 0.057). The mean onset time of motor block in group A was 15.26 ± 1.96 min, and in group B was 11.58 ± 2.68 min and this difierence isstatistically significant (p value=0.000152). Duration of motor block was 96.30 min and 115.08 min in group A and Group B respectively. Sensory block was 157.26 min and 188.0 min in group A and Group B respectively. Regarding the heart rate, no significant difference was detected between the groups at the time of preanesthesia and at the 5 min after anaesthesia. Compared with group B patients, group A patients shows slight but statistically significant increased heart rate at the 10 min (80, 92 beat/min respectively) after brachial plexus block. At 30 minute after, mean systolic BP was 97.9±4.7 mmHg in group A and 84.3±5.0 mmHg in group B. At 45 minute after, mean systolic blood pressure was 94.6±15.6 mmHg and 84.3±5.0 mmHg in group A and group B respectively. At 60 minutes after, mean systolic blood pressure was 59.6±6.0 mmHg in group A and 61.2±9.4 mmHg in group B. At 15, 30 and 45 minute difference was statistically significant (p<0.05) between two groups. In conclusion, the study revealed that verapamil can be used as an adjuvant to decrease the onset time of sensory and motor blocks of bupivacaine in supraclavicular block. Moreover, verapamil doses in regional blocks did not show any hemodynamic side effects. Bangladesh Med J. 2017 May; 46 (2): 43-47

COMPARISON OF EFFECT OF 0.25% BUPIVACAINE ALONE AND 0.25% BUPIVACAINE WITH DEXMEDETOMIDINE IN BRACHIAL PLEXUS BLOCK THROUGH SUPRACLAVICULAR APPROACH

2021 ◽  
pp. 77-79
Author(s):  
Palle Krishna Padma Sri ◽  
Niyaz PV ◽  
Madhusudhan Reddy K ◽  
Bonthu Mounica
Keyword(s):  
Brachial Plexus ◽  
Motor Block ◽  
Brachial Plexus Block ◽  
Distilled Water ◽  
Double Blind ◽  
Supraclavicular Approach ◽  
Group A ◽  
Group B ◽  
Plexus Block

BACKGROUND AND AIM:Brachial plexus block is a safe, effective, low-cost anesthesia with good postoperative analgesia. Adjuvants to local anesthetics may enhance the quality and duration of analgesia. The aim of the study was to study the efcacy of a combination of 0.25% bupivacaine alone versus 0.25% bupivacaine and dexmedetomidine in brachial plexus block by supraclavicular approach. METHODS: This is a prospective double-blind study conducted on sixty patients of ASA1 and ASA2 posted for upper limb surgeries, randomized in a double-blind fashion into two groups. Group A (N-30) received 34ml of 0.25% bupivacaine with 0.5ml of distilled water and group B (N-30) received 0.5ml dexmedetomidine (50 μg) with 34ml of 0.25% bupivacaine as supraclavicular brachial plexus block with help of a nerve stimulator. Onset and recovery time of sensory and motor block, duration of analgesia, sedation scores, quality of block, and side effects compared in both groups. RESULTS: Baseline characteristics were well matched in both groups. The intraoperative hemodynamic recording was done at 15 min time intervals from the administration of the drugs. There was a reduction in heart rate, systolic blood pressure, and diastolic blood pressure 30 mins onwards in both groups. There was no signicant difference in the onset of sensory and motor blocks. Duration of sensory block was 299.57 ± 35.94 mins in Group A and 782.2 ± 82.76 mins in Group B, duration of motor block was 272.17 ± 37.31 mins versus 755.63 +/- 86.6 mins respectively, total duration of analgesia was 321 ± 35.46 mins versus 815.80 +/- 88.1 mins respectively. Ramsay sedation score was similar at arrival in both groups but in post-op, the score of 3 was noted in 0% (0/ 30) in Gr A and 93.3% (28/ 30) in Gr B . Quality of analgesia was also better in Group B. There were no signicant adverse events noted in both groups. CONCLUSION: This double-blind Randomized Controlled study showing the combination of dexmedetomidine 50 μg with 34ml of 0.25% bupivacaine is better than 0.5ml of distilled water with 34ml of 0.25% bupivacaine in the duration of sensory and motor block, with better sedation and quality of analgesia with the good safety prole in brachial plexus block by supraclavicular approach.

Sign in / Sign up

Export Citation Format

Share Document