scholarly journals Efficacy and Safety of Fentanyl as An Adjuvant with Bupivacaine and Lignocaine in Supraclavicular Brachial Plexus Block

2019 ◽  
Vol 17 (2) ◽  
pp. 31-35
Author(s):  
Sanjida Hasan ◽  
Ahmed Abu Nasar Chowdhury ◽  
Syeda Nafisa Khatoon ◽  
Md Harun OR Rashid ◽  
Md Rezaul Hoque Tipu ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Motor Block ◽  
Brachial Plexus Block ◽  
Efficacy And Safety ◽  
College Hospital ◽  
Analgesic Effects ◽  
Upper Limb Surgery ◽  
Supraclavicular Brachial Plexus Block ◽  
Supraclavicular Block ◽  
Plexus Block

Background: Adding narcotics to local anesthetic is very effective in prolonging the analgesic effects. The aim of this study is to evaluation the efficacy and safety of fentanyl as an adjuvant with bupivacaine-lignocaine in supraclavicular block. Methods: This analytical study was carried out in the department of anesthesiology in Chittagong Medical College Hospital in collaboration with the department of orthopedic surgery over a period of 22 months starting from January 2012 to December 2014. A total 130 adult patients of either sex with American Society of Anesthesiology (ASA) health status I-II were selected for upper limb surgery under supraclavicular brachial plexus block was randomly allocated in to two groups of 65 patients in each. Group- C was received Distilled water 2ml and Group-F was received fentanyl 2ml (100 g) in 38ml of bupivacaine and lignocaine with adrenaline (Total volume of 40ml). Results: The mean onset of sensory & motor block was 10.49±0.75 min & 9.41±0.76 min in group-C and 7.60±3.711min & 9.23±5.114min in group-F. The duration of analgesia in group-C was 3.81±0.88 hrs and in group-F was 8.62±1.747 hrs. Conclusion: There was significantly prolonged duration of analgesia and better onset of sensory and motor block in fentanyl group without any unwanted effects. Chatt Maa Shi Hosp Med Coll J; Vol.17 (2); Jul 2018; Page 31-35

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 prospective randomised study of adjuvants for supraclavicular brachial plexus block: Clonidine vs Dexamethasone

2021 ◽  
Vol 8 (4) ◽  
pp. 511-514
Author(s):  
Akanksha Aggarwal ◽  
Nimit Gandhi
Keyword(s):  
Brachial Plexus ◽  
Upper Limb ◽  
Local Anaesthetic ◽  
Motor Block ◽  
Brachial Plexus Block ◽  
Upper Limb Surgery ◽  
Supraclavicular Brachial Plexus Block ◽  
Group 2 ◽  
Plexus Block ◽  
Group 1

 Supraclavicular brachial plexus block is among foremost technique of regional anaesthesia administered during upper-limb surgery. Different adjuvants have been used with varied results for prolonging the sensory and motor blockade. Dexamethasone and Clonidine have been established as suitable adjuvants for blocks. Adding adjuvants to local anaesthetic drugs in nerve blocks has many benefits. We studied performance of dexamethasone or clonidine as additives to local anaesthetic in subclavian perivascular block as a part of upper limb surgery. Aim was to ascertain which of them is a better adjuvant. Study population was randomized to 2 groups of 50 patients each. Group 1 was given 5 ml of 2% lignocaine and 15 ml 0.5% bupivacaine with 8mg dexamethasone. Group 2 received 5ml 2% lignocaine and 15 ml 0.5% bupivacaine with 0.150 mg clonidine. Time to establishment of sensory & motor block, duration of analgesia and any adverse effects were observed. Statistical analysis was done with SPSS 13.0. Quantitative variables were assessed using student t test. Qualitative variables were analysed using Chi square test. P value &#60; 0.05 was defined as significant. Onset of sensory blockade was at 7.23+4.24 in group 1 and 8.36+2.68 minutes in Group 2. Average time to motor block was at 8.48+3.22 minutes in Group 1 and 9.58+3.71 minutes in Group 2. Analgesia’s duration in Group 1 and Group 2 was 998.2+338.5 and 879.3+284.5 minutes respectively. No major adverse events were seen in either group. Performance of dexamethasone was similar to clonidine as adjunct to local anaesthetic in subclavian perivascular approach of brachial plexus block. However, it has faster sensory and motor blockade’s onset. Analgesia’s duration observed was found to be longer, though the difference was statistically insignificant.

scholarly journals EVALUATION OF ANALGESIC EFFICACY OF DEXMEDETOMIDINE AS AN ADJUVANT CO-ADMINISTERED WITH 0.75% ROPIVACAINE BY SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK FOR UPPER LIMB SURGERY

2020 ◽  
pp. 25-27
Author(s):  
Bimal Kumar Hajra ◽  
Stuti Chakraborty ◽  
Keka Pandey ◽  
Debarshi Jana
Keyword(s):  
Brachial Plexus ◽  
Upper Extremity ◽  
Upper Limb ◽  
Motor Block ◽  
Brachial Plexus Block ◽  
Analgesic Efficacy ◽  
Cost Effective ◽  
Upper Limb Surgery ◽  
Supraclavicular Brachial Plexus Block ◽  
Plexus Block

INTRODUCTION Brachial plexus block is a regional anesthesia technique that is sometimes employed as an alternative or as an adjunct to general anesthesia for surgery of the upper extremity. This technique involves the injection of local anesthetic agents in close proximity to the brachial plexus, temporarily blocking the sensation and ability to move the upper extremity. OBJECTIVES To compare time of onset and duration of sensory and motor block between two groups. To compare peri-operative and post-operative analgesia between two groups MATERIAL AND METHOD Orthopaedic operation theatre, post-anaesthesia care unit, orthopaedic post- operative ward of Nil Ratan Sircar Medical College and Hospital. All the ASA physical status I and II patients of either sex, age between 18-60 years undergoing upper limb orthopaedic surgery under supraclavicular brachial plexus block. CONCLUSION Addition of Dexmedetomidine to ropivacaine in supraclavicular brachial plexus block significantly prolongs the duration of analgesia and motor block in patients undergoing upper limb surgeries and is a remarkably safe and cost effective method of providing post-operative analgesia.

scholarly journals Comparative Study between the Effect of Perineural versus Intravascular Dexmedetomidine in Ultrasound-Guided Supraclavicular Brachial Plexus Block

2020 ◽  
pp. 37-45
Author(s):  
Mahmoud A. Al Mohasseb ◽  
Wael E. Messbah ◽  
Sabry M. Amin ◽  
Nadia H. Fattooh
Keyword(s):  
Brachial Plexus ◽  
Normal Saline ◽  
Motor Block ◽  
Brachial Plexus Block ◽  
Group Iii ◽  
Group I ◽  
Upper Limb Surgery ◽  
Supraclavicular Brachial Plexus Block ◽  
Group Ii ◽  
Plexus Block

Background: Augmentation of postoperative analgesia with various adjuvants has become a standard in regional anesthesia. There are no studies about dexmedetomidine multiple approaches in supraclavicular brachial plexus block (BPB) was contrasted. We compare perineural dexmedetomidine and intravenous dexmedetomidine Bupivacaine as adjuvant in supraclavicular brachial plexus block. Materials and Methods: This prospective randomized controlled double-blind study was conducted on 120 patients with age between 20 and 60 years, both sexes, scheduled for elective upper limb surgery. Patients were randomly allocated into 3 groups, 40 patients in each received plain bupivacaine 0.5% (20 ml) in supraclavicular BPB; group I (Control group): add 1 mL normal saline perineural, group II: Bupivacaine with perineural dexmedetomidine (BDP) add 1 μg.kg-1dexmedetomidine perineurally. group III: Bupivacaine with intravenous dexmedetomidine (BDV) add 0.5 μg.kg-1 dexmedetomidine in 50 mL of normal saline administered as infusion over 10 min. Onset and duration of sensory and motor blocks, hemodynamic variables, adverse effects, and duration of analgesia were assessed. Results: Heart rate and mean arterial pressure was significantly decrease in group III &group II compared to group I were compared by ANOVA (F) test. onset of sensory &motor block was statistically significant shorter in group II compared to group I & III. Duration of sensory &motor block was statistically significant longer in group II compared to group I & III. there was statistically significant decrease VAS in group II were analysed using Kruskal-Wallis test between three groups. There was statistically significant increase RSS in group II & III. The first time of analgesic request was statistically significant prolonged in duration in group II. Conclusion: Perineural dexmedetomidine (1 µg/ kg) as an adjuvant to bupivacaine is significantly high thanIV dexmedetomidine (0.5 µg/ kg) and bupivacaine alone in supraclavicular BPB as regards to the onset and the duration of sensory block, so Increasingpostoperative analgesia.

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.

A STUDY TO COMPARE THE EFFICACY OF BUPIVACAINE ALONE AND BUPIVACAINE PLUS DEXAMETHASONE IN SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK

2021 ◽  
pp. 1-3
Author(s):  
Rupesh Kumar Mishra ◽  
Rahul Kumar ◽  
Chandeshwar Choudhary ◽  
Debarshi Jana
Keyword(s):  
Brachial Plexus ◽  
Brachial Plexus Block ◽  
Age Groups ◽  
Onset Time ◽  
Nerve Blocks ◽  
Anesthetic Care ◽  
Duration Of Surgery ◽  
Supraclavicular Brachial Plexus Block ◽  
Supraclavicular Block ◽  
Plexus Block

Peripheral nerve blocks can be used for anesthesia, postoperative analgesia, diagnosis and treatment of chronic pain disorders. Skilful application of peripheral nerveblockade broadens the anesthesia provider's range of options in providing optimal anesthetic care. These techniques can be used in all age groups, with appropriate selection and sedation. Present prospective, randomized, double blinded study was conducted at Department of Anaesthesiology, SKMCH, Muzaffarpur, Bihar. Total Sixty consecutive adult patients undergoing upper limb orthopaedic surgeries under supraclavicular block were studied. The patients were drafted in the study after obtaining written informed consent from them. Patients divided in two groups : No statistically signicant difference in the demographic parameters and duration of surgery between the two groups was noted. We, therefore, conclude that addition of 8 mg dexamethasone to bupivacaine 0.25% solution in supraclavicular brachial plexus block. 1) Prolongs the duration of sensory and motor blockade. 2) Reduces the requirement of rescue analgesic in postoperative period. 3) Has no effect on the onset time of sensory and motor blockadc

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