scholarly journals Physiological Responses and Gene Expression in Ultrasound-Guided Supraclavicular Brachial Plexus Block: a Comparative Study

2018 ◽  
Vol 46 (6) ◽  
pp. 2412-2420 ◽  
Author(s):  
Hayam G Sayyed ◽  
Naglaa K. Idriss ◽  
Marwa A. Gaber ◽  
Sherif Sayed ◽  
Rasha Ahmed
Keyword(s):  
Oxidative Stress ◽  
Brachial Plexus Block ◽  
Mrna Levels ◽  
Oxidative Stress Markers ◽  
Ultrasound Guided ◽  
Stress Markers ◽  
Pain Scores ◽  
Tnf Α ◽  
Supraclavicular Brachial Plexus Block ◽  
Plexus Block

Background/Aims: Ultrasound-guided supraclavicular brachial plexus block (BPB) has come into wider use as a regional anesthetic during upper limb operations. This study assessed the neurological and hemodynamic changes and gene expression after co-administration of midazolam or neostigmine with bupivacaine during supraclavicular BPB. Methods: The study involved 90 adults divided into three groups: control (bupivacaine), midazolam (bupivacaine plus midazolam), and neostigmine (bupivacaine plus neostigmine). Blood samples were taken and interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) mRNA levels were measured by real-time PCR, and oxidative stress markers were identified. In addition to the hemodynamic variables, the onset and duration of sensory and motor blockades, duration of analgesia, pain scores, time of first request for an analgesic, and amounts of analgesics ingested were evaluated. Results: Compared with the control and neostigmine groups, the midazolam group experienced longer sensory and motor blockades, prolonged analgesia, lower pain scores at 12 h and 24 h, and lower need for postoperative analgesics. Moreover, the midazolam group exhibited lower oxidative stress markers with a higher fold change in IL-6 and TNF-α mRNA levels. Conclusion: Midazolam co-administered with bupivacaine provided better analgesic quality than did neostigmine with bupivacaine. This might be due to its superior antioxidant and anti-inflammatory effects.

scholarly journals Topamax® and Ginger Oil Potential Neurotoxicity And Their Interaction in Mice Thru Oxidative Stress and Inflammatory Markers, Neurotransmitters Expression and Immunohistochemical Measurements

2022 ◽  
Author(s):  
Dalia M Mabrouk ◽  
Aida El makawy ◽  
Kawkab A Ahmed ◽  
Faten M Ibrahim
Keyword(s):  
Oxidative Stress ◽  
Histopathological Examination ◽  
Immune Reactivity ◽  
Mrna Levels ◽  
Oxidative Stress Markers ◽  
Gamma Aminobutyric Acid ◽  
Necrosis Factor Alpha ◽  
Stress Markers ◽  
Tnf Α ◽  
Factor Alpha

Abstract Background: Topamax® ® has multiple pharmacological mechanisms that are efficient to treat epilepsy and migraine. Ginger has been demonstrated to have gingerols and shogaols compounds that proven to cross the blood-brain barrier causing migraine relief, implying that it is useful in the treatment of migraines. Moreover, Topamax has many off-label uses. So it was necessary to explore the possible neurotoxicity of Topamax®, Ginger oil and their interaction in the mice brain. Methods and Results: Male mice were orally gavage with Topamax®, ginger oil (400mg/kg), and Topamax® plus ginger oil with the same pattern for one month. Oxidative stress markers, acetylcholinesterase (AchE) and gamma aminobutyric acid (GABA) and tumor necrosis factor-alpha (TNF- α), were analyzed in brain tissue. Histopathological examination by hematoxylin and eosin, immunohistochemical glial fibrillary acidic protein (GFAP), and Bax expression analysis were done. The mRNA levels of GABAAR subunits, Gabra1, Gabra3, and Gabra5 were evaluated by RT qPCR. The analysis of data revealed that Topamax® elevated the levels of oxidative stress markers, neurotransmitters, TNF-α, and diminished the level of glutathione reduced (GSH). Topamax® exhibited various neuropathological alterations, strong Bax expression, and GFAP immune-reactivity in the cerebral cortex. The interaction effect of Topamax® plus ginger oil attenuated the changes induced by Topamax® in the abovementioned parameters. Both Topamax® and ginger oil upregulated the mRNA expression of gabra1 and gabra3 while their interaction markedly downregulated them. Conclusion: We can conclude that the Topamax® overdose could possibly cause neurotoxicity, but the interaction with ginger oil can reduce Topamax® -induced neurotoxicity and should be taken in parallel.

scholarly journals Ultrasound-guided supraclavicular brachial plexus block in a patient with a cervical rib

2015 ◽  
Vol 62 (6) ◽  
pp. 671-673 ◽  
Author(s):  
Tatsunori Watanabe ◽  
Kazuhito Yanabashi ◽  
Koji Moriya ◽  
Yutaka Maki ◽  
Naoto Tsubokawa ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Brachial Plexus Block ◽  
Ultrasound Guided ◽  
Cervical Rib ◽  
Supraclavicular Brachial Plexus Block ◽  
Plexus Block

scholarly journals Comparison of effects of dexmedetomidine and clonidine as adjuvant to bupivacaine 0.25% in ultrasound guided supraclavicular brachial plexus block

2017 ◽  
Vol 5 (10) ◽  
pp. 4512 ◽  
Author(s):  
Usha K. Chaudhary ◽  
Amruth Danesh ◽  
Monika Mahajan ◽  
Sudarshan Kumar ◽  
Versha Verma ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Upper Limb ◽  
Brachial Plexus Block ◽  
Categorical Variables ◽  
Control Group ◽  
Double Blind Study ◽  
Continuous Variables ◽  
Ultrasound Guided ◽  
Supraclavicular Brachial Plexus Block ◽  
Plexus Block

Background: Ultrasound guided brachial plexus block is the preferred technique for surgeries on upper limb. Adjuvants are usually added to peripheral nerve blocks to increase their analgesic efficiency and duration. We compared analgesic effects of dexmedetomidine 1mcg/kg and clonidine 1mcg/kg as adjuvant to a low volume of bupivacaine in USG guided supraclavicular brachial plexus block.Methods: A prospective, randomized controlled, double blind study planned after permission from institutional ethics committee. Sixty ASA grade I, II patients, 18-60 years undergoing upper limb orthopedic surgery included. Group 1 (Control group) received 20 ml of 0.25% bupivacaine. Group 2 (Dexmedetomidine group) received 20ml of bupivacaine + dexmedetomidine (10 ml of 0.5% bupivacaine + 1µg/kg of dexmedetomidine, diluted with 0.9% NS to 20 ml) Group 3 (Clonidine group) received 20 ml of 0.25 bupivacaine + clonidine (10ml of 0.5% bupivacaine+1µ g/kg of clonidine, diluted with 0.9% NS to 20 ml) in USG guided supraclavicular brachial plexus block. Continuous variables analyzed with analysis of variance or Kruskal-Wallis test and categorical variables with Fisher’s exact test.Results: Pain free period was 864.90±357.16 minutes: dexmedetomidine group; 584.59±172.38 minutes: clonidine group, 431.78±138.40 minutes: control group with p< 0.001. VRS (verbal rating score) was significantly higher in control group as compared to dexmedetomidine at 4 hours but the pain scores were comparable between all the groups after 8 hours of block.Conclusions: Dexmedetomidine as an adjuvant to bupivacaine provides prolonged anaesthesia, better pain relief in early postoperative period with haemodynamically stable, calm patients compared to clonidine and control group.

scholarly journals A Rare Complication in Ultrasound-guided Supraclavicular Brachial Plexus Block

2016 ◽  
Vol 1 (1) ◽  
pp. 30-31
Author(s):  
Sindil Kumar Sahu ◽  
Usha Badole
Keyword(s):  
Brachial Plexus ◽  
Recurrent Laryngeal Nerve ◽  
Nerve Palsy ◽  
Brachial Plexus Block ◽  
Rare Complication ◽  
Recurrent Laryngeal Nerve Palsy ◽  
Laryngeal Nerve ◽  
Ultrasound Guided ◽  
Supraclavicular Brachial Plexus Block ◽  
Plexus Block

ABSTRACT Orthopaedic upper limb surgeries are commonly performed under brachial plexus block. Ultrasound guidance significantly improves the quality of nerve block with lesser number of complications, although complications cannot be eliminated completely. Ipsilateral recurrent laryngeal nerve palsy is a rare complication associated with supraclavicular approach. We report a case of 28 year old female who developed hoarseness of voice following ultrasound guided supraclavicular brachial plexus block. The diagnosis of ipsilateral recurrent laryngeal nerve palsy requires a high index of suspicion and it should always be kept in differential diagnosis when a patient develops hoarseness of voice or respiratory compromise after supraclavicular brachial plexus block. How to cite the article Sahu SK, Badole U. A Rare Complication in Ultrasound-guided Supraclavicular Brachial Plexus Block. Res Inno Anaesth 2016;1(1):30-31.

scholarly journals Effect of Midazolam and 0.5% Levobupivacaine Combination in Ultrasound-guided Supraclavicular Brachial Plexus Block for Upper Limb Surgeries - A Clinical Study

2016 ◽  
Vol 10 (1) ◽  
pp. 27-33
Author(s):  
Bhawana Rastogi ◽  
Ankush Arora ◽  
Kumkum Gupta ◽  
Manish Jain ◽  
Vijendra Pal Singh ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Motor Block ◽  
Brachial Plexus Block ◽  
Motor Blockade ◽  
Ultrasound Guided ◽  
End Points ◽  
Supraclavicular Brachial Plexus Block ◽  
Vas Scores ◽  
The Mean ◽  
Plexus Block

Background: The present study was designed to evaluate the hypothesis that midazolam as an adjuvant to levobupivacaine would safely enhance the duration of analgesia without any adverse effects when compared with levobupivacaine alone, in ultrasound-guided supraclavicular brachial plexus block. Primary end points were the duration of sensory and motor block and secondary end points were sedation score and any other complications. Patients and Method: Eighty consenting patients of both sexes, aged 18-60 years of ASA physical status I-II were randomized into two groups of 40 patients each. Patients in Group LS received 19 ml of 0.5% levobupivacaine with 1 ml normal saline and patients in Group LM received 19 ml of 0.5% levobupivacaine with 1ml midazolam (50µg/kg) for supraclavicular brachial plexus block using ultrasound guidance. Onset time and duration of sensory and motor blockade and VAS scores were assessed as primary end points. Hemodynamic changes, sedation or any other drug or technique related adverse effects were taken as secondary effects. Results: Onset of sensory and motor blockade was lower in patients of Group LM. The mean duration of sensory analgesia was significantly prolonged in patients of Group LM (537.6 ± 101.01 vs. 319.80 ± 87.09 mins). The mean duration of motor blockade was also significantly enhanced in patients of Group LM (405.0 ± 61.62 mins) compared to Group LS (274.8 ± 46.30 mins). VAS scores were higher in Group LS than group LM. Sedation scores were similar in both the groups. Conclusion: Midazolam with 0.5% levobupivacaine has effectively enhanced the duration of sensory and motor block without significant sedation and any other side effect.

scholarly journals A comparative study of intravenous versus perineural administration of dexmedetomidine in supraclavicular brachial plexus block using 0.75% ropivacaine by ultrasound guided technique in upper limb surgeries

2018 ◽  
Vol 6 (7) ◽  
pp. 2407
Author(s):  
Fahad Khan ◽  
V. P. Singh
Keyword(s):  
Comparative Study ◽  
Brachial Plexus ◽  
Upper Limb ◽  
Brachial Plexus Block ◽  
Elective Surgery ◽  
Study Drug ◽  
Sensory Block ◽  
Ultrasound Guided ◽  
Supraclavicular Brachial Plexus Block ◽  
Plexus Block

Background: Comparative study of intravenous versus perineural administration of dexmedetomidine in supraclavicular brachial plexus block using 0.75% ropivacaine by ultrasound guided technique in upper limb surgeries.Methods: Patients in the age group 18-58 years both male and female, having ASA 1 and ASA 2, scheduled for elective surgery of unilateral upper limb surgeries were included and randomly divided into three groups’ i.e. group RD, group RDI and group R and patients with chronic pain or taking any analgesics, ASA grade III and IV, bleeding disorders, history of brachial plexus injury, known allergy to the study drug, previous shoulder surgery, any psychiatric disorders, peripheral neuropathy, failed block, significant respiratory disease, hearing impairment, pregnant women, study were excluded.Results: Time to sensory onset in group RD was as compared to group RDI and group R was found statistically significant (p<0.001). Duration of sensory block (analgesia) in group RD, group RDI and Group R was also statistically significant (p<0.001). The level of sedation of Group RDI and Group RD had highly significant value till 30 mins (p<0.001).Conclusions: The central effects of dexmedetomidine also play some role in prolongation of sensory and motor block duration, as explained previously.

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