scholarly journals Bupivacaine-dexmedetomidine versus bupivacaine-nalbuphine in ultrasound-guided supraclavicular brachial plexus block: a prospective, randomized, double-blind study

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
H. S. Mohamed ◽  
G. S. Gad
Keyword(s):  
Brachial Plexus ◽  
Brachial Plexus Block ◽  
Isotonic Saline ◽  
Double Blind Study ◽  
Motor Blockade ◽  
Double Blind ◽  
Upper Limb Surgery ◽  
Supraclavicular Brachial Plexus Block ◽  
Post Operative Nausea ◽  
Plexus Block

Abstract Background Brachial plexus block is frequently performed for ambulatory upper limb surgery as an alternative to general anesthesia. It can significantly reduce pain, reduce post-operative nausea, and vomiting and allowing for faster discharge from hospital. Performing this block under ultrasound guidance has higher index of safety and can monitor the distribution of local anesthetic (LA) in real time. The aim of this study is to compare the block characteristics among bupivacaine-dexmedetomidine (BD), bupivacaine–nalbuphine8 (BN), and bupivacaine-isotonic saline groups. Results The duration of both the sensory and motor blockade was statistically longer in both BD and BN groups with a longer duration of analgesia compared to the BS group. Also, the BD group showed statistically significant higher sedation scores at different times during the study compared with both the BN and BS groups. Conclusion Adding either dexmedetomidine or nalbuphine to isobaric bupivacaine in US-guided supraclavicular brachial plexus block prolongs both sensory and motor blockade. Dexmedetomidine produces significant sedation when added to bupivacaine.

scholarly journals A comparison of ultrasound versus paresthesia technique for supraclavicular brachial plexus block

2017 ◽  
Vol 4 (1) ◽  
pp. 198
Author(s):  
Bidyut Borah ◽  
Smita R. Engineer ◽  
Kiran B. Patel
Keyword(s):  
Brachial Plexus ◽  
Brachial Plexus Block ◽  
Motor Blockade ◽  
Ultrasound Guided ◽  
Ultrasound Technique ◽  
Sensory Blockade ◽  
Upper Limb Surgery ◽  
Supraclavicular Brachial Plexus Block ◽  
Patient Groups ◽  
Plexus Block

Background: Ultrasonography is a newer tool for identification of nerves in the practice of regional anaesthesia. Visualization of target structures and spread of drugs under direct vision and thus avoiding complications like pneumothorax, accidental intravascular injections are potential benefit of ultrasonography technique. Aim of the study was to examine the usefulness of ultrasound guided brachial plexus block and compare it with paresthesia technique with the believe that ultrasound guidance can shorten the onset as well as increase the duration of blockade..Methods: Eighty patients of either sex, 18-60 years, posted for upper limb surgery were divided into 2 groups according to the technique used to give block, group US (ultrasound technique) and group PA (paresthesia technique).  Both the groups received 0.5 % bupivacaine 20 ml with 8 mg of dexamethasone.Results: There was notable difference between the patient groups with regard to initiation of motor blockade (10 min group US vs 11.1 min group PA, p <0.0156) and sensory blockade (5.16 min group US vs 6.96 min group PA, p <0.0001) also duration of motor blockade (1272.88 min in group US vs 899.25 min in group PA, p <0.0001) and sensory blockade (1343.88 min in group US vs 996.75 min in group PA, p<0.0001).Conclusions: Ultrasound guided supraclavicular brachial plexus blocks result in a higher success rate with respect to onset and duration of blockade with less incidence of complications compared to paresthesia technique.

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

Effect of Dexamethasone on The Duration of Analgesia for Supraclavicular Brachial Plexus Block

KYAMC Journal ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 199-203
Author(s):  
Md Rafiqul Islam ◽  
Laila Yesmin ◽  
Md Pervez Rahman ◽  
ABM Shafiul Anam Khan ◽  
Md Miraj Hossain ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Motor Block ◽  
Brachial Plexus Block ◽  
Onset Time ◽  
Double Blind Study ◽  
Double Blind ◽  
Significant Difference ◽  
Supraclavicular Brachial Plexus Block ◽  
Group B ◽  
Plexus Block

Background: Brachial plexus block with Bupivacaine provides effective intraoperative anesthesia and analgesia. The use of dexamethasone along with local anesthetic has been shown to improve the duration of analgesia. Objective: To observe the effect of Dexamethasone on the duration of analgesia for Supraclavicular Brachial plexus block. Materials and Methods: A prospective, double-blind study was undertaken in patients scheduled for upper limb surgeries under supraclavicular brachial plexus block. patients were randomly divided into two groups, Group (BD) and B. Group B received 28 ml of 0.25% bupivacaine with 2 ml normal saline while Group BD received 28 ml of 0.25% bupivacain with 2ml (8mg) dexamethasone for supraclavicular brachial plexus block. The groups were compared regarding quality of sensory and motor blockade. All the information was recorded in data collection sheet. Data was processed and analysed with the help of computer program SPSS and Microsoft excel. Results: There was no significant difference between groups in respect of demographic and American Society of Anaesthesiologist (ASA) status. Mean age was found to 34.7±8.53 years. In Group (BD) , 63.3% were ASA I and 36.6% were ASA II. In Group B, 60% were ASA I and 40% were ASA II. It has become evident that satisfactory anaesthesia can be made possible by addition of adjuvant to local anaesthetic in brachial plexus block (in Group-BD). onset of sensory block was faster in Group BD (8.17 ± 1.4 min) than Group B (9.12 ± 1.68 min). Similarly mean onset time of motor block in group A was 12.26 ± 3.96 min, and 11.58 ± 3.68 min in group B. Our study shows that duration of motor block was 408.68±26.96 min and 380.26 ± 24.11 min in group BD and Group B respectively. Conclusion: There was significantly prolonged duration of analgesia in addition of Dexamethasone without any unwanted effects. KYAMC Journal Vol. 11, No.-4, January 2021, Page 199-203

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