scholarly journals Evaluation of the Efficacy of Magnesium Sulphate as an Adjuvant to Lignocaine for Intravenous Regional Anaesthesia for Upper Limb Surgery

2008 ◽  
Vol 36 (6) ◽  
pp. 840-844 ◽  
Author(s):  
S. Narang ◽  
J. S. Dali ◽  
M. Agarwal ◽  
R. Garg
Keyword(s):  
Upper Limb ◽  
Normal Saline ◽  
Magnesium Sulphate ◽  
Regional Anaesthesia ◽  
Motor Block ◽  
Sensory Block ◽  
Tourniquet Pain ◽  
Upper Limb Surgery ◽  
Significant Difference ◽  
Intravenous Regional Anaesthesia

Several additives have been combined with local anaesthetics for intravenous regional anaesthesia to improve block quality, analgesia and to decrease tourniquet pain. Magnesium sulphate is one potential additive. This prospective, randomised, double-blinded study was conducted in 30 ASA physical status I or II patients undergoing upper limb surgery under tourniquet. In group L, patients received intravenous regional anaesthesia with lignocaine alone (9 ml of 2% lignocaine diluted with normal saline to total volume of 36 ml). Patients in group M received intravenous regional anaesthesia with lignocaine plus magnesium sulphate (6 ml of 25% magnesium sulphate plus 9 ml of 2% lignocaine diluted with normal saline to total volume of 36 ml). Assessment was by observing the response to injection of drug; sensory and motor block and tourniquet pain. The mean time of onset of sensory block was 12.40 and 3.47 minutes in groups L and M respectively (P <0.001). The average times of onset of motor block in groups L and M were 17 and six minutes respectively (P <0.001). Of the patients in group M, 66.7% reported moderate to severe pain while the drug was being injected, compared to 20% in group L (P=0.011). There was a statistically significant difference in visual analogue scale for tourniquet pain at 10 and 30 minutes after tourniquet inflation (lower in group M). These findings indicate that magnesium sulphate added as an adjuvant to lignocaine hastens the onset of sensory and motor block and decreases tourniquet pain. However, there is increased incidence of transient pain on injection if magnesium sulphate is added.

scholarly journals Comparison of magnesium sulphate as an adjuvant to lignocaine with lignocaine alone in intravenous regional anaesthesia for upper limb surgery in improving tourniquet pain.

2020 ◽  
Vol 27 (06) ◽  
pp. 1311-1315
Author(s):  
Syed Mehmood Ali ◽  
Sadaf Bokhari ◽  
Hajra Shuja
Keyword(s):  
Magnesium Sulfate ◽  
Upper Limb ◽  
Magnesium Sulphate ◽  
Regional Anaesthesia ◽  
Control Group ◽  
Analgesic Requirement ◽  
Tourniquet Pain ◽  
Upper Limb Surgery ◽  
Intravenous Regional Anaesthesia ◽  
Mean Time

Objectives: To compare mean time to the first analgesic requirement with the Magnesium sulfate with lignocaine and lignocaine alone under intravenous regional anaesthesia for upper limb surgery. Study Design: Randomized Controlled Trial. Setting: Operative Rooms of Shaikh Zayed Hospital, Lahore. Period: October 2, 2018 to April 2, 2019. Material & Methods: For the analysis, a total of 150 (75 subjects per group) were selected that fulfilled the inclusion criteria. Those subjects were allocated by the use of the tables to two separate anesthetic regimes. Lignocaine plus magnesium sulphate was given to experimental group (M) as an adjunct and control group (L) was given simple IVRA with lignocaine. Mean Atrial Pressure, Heart Rate, and SpO2 were tracked every 2 minutes after start of anesthesia before and after use of the tourniquet. All the patients will be counseled to report if they experience tourniquet pain. When patients complained of tourniquet pain it was assessed on VAS of l-10 and patient was given analgesia if pain >3 on VAS. The data were collected and analyzed in SPSS v25.0. The median time for analgesics was used in both groups for the analysis of the independent t-test. A p-value of 0.05 was estimated significant. Results: 150 patients were enrolled. Mean time to first analgesic requirement is greater with the Magnesium sulfate with lignocaine and lignocaine alone in patients undergoing upper limb surgery under intravenous regional anaesthesia 51.9±4.2 minutes vs. 32.1±4.4 minutes (p=0.000). Conclusion: The findings indicate that the tourniquet pain is reduced by adding magnesium sulphate as an adjuvant to lignocaine.

scholarly journals COMPARISION OF ROPIVACAINE AND BUPIVACAINE IN SUPRACLAVICULAR BRACHIAL PLEXSUS BLOCK

2020 ◽  
pp. 17-19
Author(s):  
Prajapati Jigar s ◽  
Alka Shah ◽  
Pujaben barad ◽  
Keta Patel ◽  
Dipesh shah
Keyword(s):  
Upper Limb ◽  
Motor Block ◽  
Tertiary Care ◽  
Residual Effect ◽  
Sensory Block ◽  
Toxic Effects ◽  
Upper Limb Surgery ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Group B

Background : Regional Anesthesia in the form of supraclavicular approach to the brachial plexus is often used for orthopedic surgeries of the upper limb. It is often used either as an adjuvant to general anesthesia or as the primary anaesthetic. Bupivacaine’s cardiac and central nervous system toxic effects in some patients prompted the researchers to develop new local anesthetic agent with a profile similar to Bupivacaine without considerable toxic effects. One such possible replacement for Bupivacaine was Ropivacaine. However Ropivacaine’s latency of sensory analgesia was approximately two thirds that of Bupivacaine, therefore it was not as effective in promoting prolonged post-operative analgesia. Method : This was a prospective randomized double blinded comparative study on all patients of orthopaedic department affiliated with tertiary care centre who was undergoing upper limb surgery during the study period. Patients with higher ASA grade (3 or 4), with severe morbidity conditions and having allergy to local anaesthetic drugs were excluded from study. A total 60 patients were selected and assigned into two groups randomly (30 in each group).Group A received 20ml of 0.75% of Ropivacaine plus Xylocaine 2% 10 ml while Group B received 20ml of 0.5% of Bupivacaine plus Xylocaine 2% 10 ml by supraclavicular route. Intraoperatively all the vital parameter monitored. At the end of surgery, the residual effect and duration of surgery noted and after shifting of patient to the ward, patients visited for the assessment. Postoperative analgesia assessed by 10 point of visual analogue scale.Results : There was no significant difference regarding age, weight and sex distribution between two groups. The Onset of sensory block of Group R is nearly 7.07+/-0.82 minutes while in Group B it is 7.1+/-0.84 minutes and the Onset of motor block in Group R is 11.23+/-1 minutes while that in group B is 11.2+/-0.99 minutes. The duration of sensory block in Group R is nearly 9.80+/-0.41 hours (548.2 ± 24.62 minutes) while that in Group B is 9.81+/-0.46 hours (589.2 ± 27.74 minutes) and the duration of motor block in Group R is 9.95+/-0.46 hours (534.4 ± 27.65 minutes) while in Group B it is 9.96+/-0.41 hours (596.0 ± 24.70 minutes).Conclusion : Onset of sensory block and onset of motor block in ropivacaine group andbupivacaine group are similar and there are no clinical and statistical differences in the two groups. Duration of sensory and duration of motor blockade in in ropivacaine group and bupivacaine group are similar and there are no clinical and statistical differences in the two groups. No differences are found in in hemodynamic parameters (HR, BP, SPO2) in the two groups. All the patients in two groups were stable hemodynamically during surgery.

Comparative study of (0.5%) levobupivacaine and (0.75%) ropivacaine in supraclavicular brachial plexus block by lateral approach

2017 ◽  
Vol 5 (6) ◽  
pp. 2426
Author(s):  
Jitesh Kumar ◽  
. Sweta ◽  
Kumari Kanak Lata ◽  
B. K. Prasad ◽  
V. K. Gupta
Keyword(s):  
Brachial Plexus ◽  
Motor Block ◽  
Brachial Plexus Block ◽  
Sensory Block ◽  
Lateral Approach ◽  
Controlled Study ◽  
Upper Limb Surgery ◽  
Significant Difference ◽  
Supraclavicular Brachial Plexus Block ◽  
Plexus Block

Background: As compared to general anaesthesia, brachial plexus block for upper limb surgery gives fewer side effects and better postoperative analgesia. The objective of this study was to evaluate the effects of 0.5% levobupivacaine and compare it with 0.75% ropivacaine.Methods: For this prospective randomized, controlled study, 60 patients of both sexes of ASA grade 1 and 2 were enrolled and divided into two groups and supraclavicular brachial plexus block was performed by lateral approach using 30 ml of 0.5% levobupivacaine and 0.75% ropivacaine. The onset of sensory and motor block, duration of sensory and motor block and analgesia and possible adverse events were recorded.Results: No statistically significant difference was observed in the onset of sensory block in both groups. Onset of motor block was significantly faster in levobupivacaine group (P<0.05). Duration of sensory block, motor block and analgesia was significantly longer in levobupivacaine group (P<0.05).Conclusions: 0.5% levobupivacaine is better alternative to 0.75% ropivacaine in brachial plexus block in term of early onset of sensory block and long duration of analgesia.

scholarly journals A comparative study to assess the efficacy of addition of dexmedetomidine to levobupivacaine in brachial plexus block

2021 ◽  
Vol 8 (2) ◽  
pp. 155-160
Author(s):  
Shabeel Aboobacker C P ◽  
Shamjith K ◽  
Melbin Baby ◽  
Salman Mohammed Kutty C
Keyword(s):  
Brachial Plexus ◽  
Upper Limb ◽  
Motor Block ◽  
Brachial Plexus Block ◽  
Tertiary Care ◽  
Random Allocation ◽  
Duration Of Action ◽  
Upper Limb Surgery ◽  
Significant Difference ◽  
Plexus Block

Brachial plexus block is one of the best surgical technique for upper limb surgeries. It is a good anesthetic and analgesic agent. Though levobupivacaine has a duration of action of three to eight hours it has an acceptable analgesic property and few other practical constraints. Addition of vasoconstrictors like α-adrenergic agonists, hyaluronidase, neostigmine, opioids have been found to be effective. Dexmedetomidine, an α2 receptor agonist has found to be a better adjuvant to levobupivacaine by few literatures. To assess the effect of levobupivacaine 0.5% alone and with dexmedetomidine 100 μg as an adjuvant to levobupivacaine 0.5% on the onset and duration of sensory and motor block, the duration of perioperative analgesia, complications and sedation score.This study was conducted after ethical committee clearance in a tertiary care medical college hospital in northern Kerala, India. 60 patients between the age of 18 and 60 years planned for upper limb surgery under brachial plexus block, who fulfilled the inclusion and exclusion criteria were included in the study. A pre anesthetic checkup was done to assess the patient before including in the study. The patients who were included in the study were randomly assigned into two groups – one group received 1 ml (100µg) dexmedetomidine with 39 ml of 0.5% Levobupivacaine(LD group) and the second group received 1 ml of 0.9% normal saline and 39 ml of 0.5% Levobupivacaine(LS group) as anesthetic agent through sealed envelope technique. The clinical history, vitals and hemodynamic parameters were monitored and noted prior to and during the surgery. The data collected was analyzed and tabulated. There was no statistically significant difference between both groups with respect to age, Gender and weight signifying proper random allocation of study subjects. None in LD group required post operative analgesia. The mean duration of onset of sensory and motor block was earlier and duration of motor and sensory analgesia was prolonged with the addition of Dexmedetomidine to Levobupivacaine. The hemodynamic stability was better with Dexmedetomidine. Bradycardia was reported in 20% of study participants who were administered dexmedetomidine Dexmedetomidine added to levobupivacaine provides better anesthetic and analgesic care in upper limb surgeries done using brachial plexus block.

scholarly journals Comparison of the Effects of Low Volume Prilocaine and Alkalinized Prilocaine for the Regional Intravenous Anesthesia Technique in Hand and Wrist Surgery

2014 ◽  
Vol 2014 ◽  
pp. 1-9
Author(s):  
Ozlem Kapusuz ◽  
Guldeniz Argun ◽  
Murat Arikan ◽  
Guray Toğral ◽  
Aysun Basarir ◽  
...  
Keyword(s):  
Motor Block ◽  
Sensory Block ◽  
Intravenous Anesthesia ◽  
Future Studies ◽  
Tourniquet Pain ◽  
Patients Satisfaction ◽  
Significant Difference ◽  
Anesthesia Technique ◽  
Low Volume

Aim. Comparing the effectivity of prilocaine and prilocaine alkalinized with 8.4% NaHCO3in terms of sensory and motor block onset and termination durations in RIVA technique considering patients’ satisfaction and tolerance with application of tourniquet undergoing hand-wrist surgery.Materials and Methods. 64 patients were randomised into two groups. First group (Group P) was administered prilocaine and second group (Group PN) was administered prilocaine + %8.4 NaHCO3. Sensory and motor block onset and termination times and onset of tourniquet pain were recorded.Results. No significant difference was found between the two groups in terms of onset and termination of sensory block and the onset of motor block. The duration of the motor block was longer in Group PN than in Group P(P<0.05). Tourniquet pain was more intense in Group P(P=0.036). In Group PN, the use of additional drugs was recorded at a lower rate and patients’ satisfaction was higher than Group P.Conclusion. In the present study, it was established that alkalinization of prilocaine had no effect on the duration of sensory block and it prolonged the duration of motor block, increased patients’ satisfaction, and decreased tourniquet pain. It is our suggestion that future studies should be carried out on the issue by using different volumes.

COMPARISON BETWEEN PERINEURAL DEXAMETHASONE AND INTRAVENOUS MAGNESIUM SULPHATE AS ADJUVANT IN SUPRACLAVICULAR BLOCK

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Ahmed Nagah El-Shaer ◽  
Ahmed Kamal Mohamed Ali ◽  
Farouk Kamal Eldeen Abd El-Aziz ◽  
Mostafa Samir El-Sayed
Keyword(s):  
Upper Extremity ◽  
Magnesium Sulphate ◽  
Regional Anaesthesia ◽  
Motor Block ◽  
Sensory Block ◽  
University Hospital ◽  
Study Patient ◽  
Rescue Analgesia ◽  
Group A ◽  
Group B

Abstract   Background: Upper extremity surgeries are commonly performed under regional anaesthesia. Regional anaesthesia of the upper extremity has several advantages over general anaesthesia such as improved postoperative pain management, decreased postoperative narcotic consumption, and reduced recovery time. Objectives: The aim of the study was to compare between dexamethasone and magnesium sulphate as adjuvants in supraclavicular brachial plexus block as regards the onset and duration of sensory and motor block as well as side effects. Patients and Methods: This prospective double-blinded comparative study was carried out in Faculty of Medicine, Ain-Shams University Hospital on 120 adult patients between 21-50 years of both sexes with ASA classification 1&2 who were scheduled for elective upper limb orthopaedic surgeries. A written informed consent was obtained from all patients. Every patient received an explanation about the purpose of the study. Procedures had been approved by the institutional and the regional ethical committee. Total 120 patients are enrolled in the study and divided into 3 groups A and B and C (40 for each one). Results From aspect of increasing the duration of sensory &motor block magnesium sulphate group (group A) showed higher prolongation of sensory & motor block with recovery of pin prick sensation in median time 313 mins ± when compared with group B &C even with longer time taken for patient to request rescue analgesia after 5 hours. In group (B) by adding dexamethasone with bupivacaine the blood pressure rate are increased after 20 min of injection and return normal after 240 min, heart rate are normal, but in case of sensory and motor block about 77.5% of study patient in this group have full motor and sensory block, in case of increasing time of motor and sensory block the dexamethasone success increasing time for motor and sensory block to reach 278 min sensory and 314 min in motor block, first call of Analgesic are after 4 hr. Conclusion: Group A (Magnesium sulphate with bupivacaine) were more effective and increasing affected time in motor and sensory block than Group B (Dexamethasone with Bupivacaine) and Group C (Control).

scholarly journals Comparison between two mixtures of lidocaine and bupivacaine for infraclavicular block: a double blind randomized trial

2020 ◽  
Vol 7 (5) ◽  
pp. 1342
Author(s):  
El Kaissi Jaber ◽  
El Moqaddem Amine ◽  
Khalil Mounir ◽  
Kechna Hicham ◽  
Hachimi Moulay Ahmed ◽  
...  
Keyword(s):  
Side Effects ◽  
Randomized Trial ◽  
Upper Limb ◽  
Motor Block ◽  
Sensory Block ◽  
Double Blind ◽  
Upper Limb Surgery ◽  
Group A ◽  
Infraclavicular Block ◽  
Group B

Background: We compare the two mixtures in terms of efficiency, analgesia, and side effects.Methods: 30 patients scheduled for upper limb surgery were randomized in 2 groups. the group A received a mixture of 50% lidocaine 2% and 50% of bupivacaine 0.5% the group B received a mixture of 75% lidocaine 1% and 25% of bupivacaine 0.5%. Volumes, block onset times, blocks duration times, analgesia, and toxicity were compared.Results: The volumes were equals in both groups. Sensory block onset was 5.43 min in the group A versus 6.73 min in the group B, motor block onset was 11.93 for the group A versus 13.46 min for the group B. Sensory block duration was 5.48 hours in the group A versus 4.05 hours for the group B (p=0.037), motor block duration was 7.75 hours for group A versus 5.50 hours for group B (p=0.014). Analgesia levels are equals between the two groups, there was no side effects listed.Conclusions: The use of low concentrated lidocaine and bupivacaine mixture induces an adequate anaesthesia and decreases the duration of motor block with a reduced level of pain and an equal level of analgesia.

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