SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK IN UPPER LIMB SURGERIES: ULTRASOUND-GUIDED VERSUS NERVE STIMULATORTECHNIQUE

2017 ◽  
pp. 104-108
Author(s):  
Van Tri Nguyen ◽  
Van Minh Nguyen
Keyword(s):  
Brachial Plexus ◽  
Success Rate ◽  
Upper Limb ◽  
Motor Block ◽  
Brachial Plexus Block ◽  
Ultrasound Guided ◽  
Group I ◽  
Supraclavicular Brachial Plexus Block ◽  
Group Ii ◽  
Plexus Block

Objective: To compare the onset and duration ofsensory and motor blockade,success and complications rate of these two techniques. Subjects and methods: One hundred and twenty patients undergoing upper limb surgeries at Hue Central Hospital from May 2016 to May 2017 were divided into two groups. Group I underwentultrasound-guided supraclavicular brachial plexus block, group II with nerve stimulator. Each group received 25ml levobupivacaine 0.5% and 1/200000 adrenalin. Results:The procedure time (9.82 ± 4.55 vs 14.73 ± 4.73 min), the onset of sensory (6.15 ± 1.60 vs 9.92 ± 2.88 min) and motor block (7.95 ± 1.05 vs 12.63 ± 2.15 min) in group I were significant shorter than in Group II (p < 0.05). The duration of sensory and motor block, (481.38 ± 116.66 vs 319.22 ± 143.14 min and 412.97 ± 107.32 vs 205.88 ± 48.96 min, respectively) were significant longer in group I than in Group II (p < 0.05). The success rate (98.3% vs 90%) and complication incidence (1.7% vs 8.4%) were comparable between two groups. Conclusion: Ultrasound guidance for supraclavicular brachial plexus blockade provided faster onset, longer duration of sensory and motor block, higher success rate with fewer complications in comparison withnerve stimulator technique Key words: brachial plexus block, ultrasound-guided

scholarly journals Dexmedetomidine and Clonidine as an Adjuvant to Bupivacaine in Ultrasound Guided Supraclavicular Brachial Plexus Block- A Randomised Clinical Trial

2021 ◽  
Author(s):  
Yuvaraj Shastri ◽  
Nanjappa Nagaraju ◽  
MS Priyanka
Keyword(s):  
Brachial Plexus ◽  
Motor Block ◽  
Brachial Plexus Block ◽  
Randomised Clinical Trial ◽  
Ultrasound Guided ◽  
Sensory Blockade ◽  
Group I ◽  
Supraclavicular Brachial Plexus Block ◽  
Group Ii ◽  
Plexus Block

Introduction: Alpha‑2 agonists are used as adjuvants with Local Anaesthetic (LA) agents to prolong the duration of regional nerve blocks. Aim: To compare clonidine and dexmedetomidine as an adjuvant to bupivacaine in supraclavicular brachial plexus block with respect to onset and duration of sensory and motor block and duration of analgesia. Materials and Methods: In this randomised clinical trial, 70 American Society of Anesthesiologists (ASA) class I and class II patients, scheduled for elective upper limb surgeries under ultrasound guided supraclavicular brachial plexus block, were divided into two equal groups. Group‑I received clonidine 1 μg/ kg and group‑II received dexmedetomidine 1 μg/kg added to bupivacaine 0.5% (20 mL). Onset and recovery time of sensory and motor block, duration of analgesia were studied in both the groups. Data analysis was done using Analysis of variance (ANOVA) and Student t‑test for analysis of continuous data and Chi‑square test used to know the difference of significance in categorical data. Results: A total of 70 subjects between age group of 18‑60 years were included in the study. The onset of sensory blockade was faster in group‑I (3.54±0.74 min) than group‑II (3.86±0.88 min) but statistically not significant. The onset of motor blockade was faster in group‑I (5.4±1.12 min) than group‑II (6.34±1.14 min) and difference was statistically significant. Duration of sensory blockade was longer in group‑I (616.23±62.05 min) than group‑II (574.71±61.14 min) and motor blockade in group‑I (635.86±57.82 min) was longer than group‑II (562.80±66.89 min) and the differences were statistically significant. The duration of analgesia was longer in group‑I (797.29±108.06 min) than group‑II (695.00±91.14 min) and the difference was statistically significant. Conclusion: Dexmedetomidine shortens the onset, prolongs the duration of sensory and motor block and also provides longer postoperative analgesia as compared with clonidine when used as an adjuvant to bupivacaine in ultrasound guided supraclavicular brachial plexus block.

scholarly journals Effect of dexamethasone as an adjuvant with bupivacaine in ultrasound guided single shot supraclavicular brachial plexus block in upper extremity surgeries- a prospective randomized study

2017 ◽  
Vol 5 (5) ◽  
pp. 2139 ◽  
Author(s):  
Shaheena Parveen ◽  
Masrat Jan ◽  
Arshi Taj ◽  
Arif A. Bhat
Keyword(s):  
Side Effects ◽  
Brachial Plexus ◽  
Upper Limb ◽  
Motor Block ◽  
Brachial Plexus Block ◽  
Sensory Block ◽  
Group I ◽  
Supraclavicular Brachial Plexus Block ◽  
Group Ii ◽  
Plexus Block

Background: Supraclavicular brachial plexus block is a good alternative to general anesthesia in surgeries of elbow, forearm, wrist and hand. The aim of this study was to assess the effect of dexamethasone as an adjuvant with bupivacaine in supraclavicular brachial plexus block in upper limb surgeries.Methods: This study was carried out on 60 adult patients of both sexes planned for upper limb surgery during the period from May 2015 to Jan 2016 after approval by the institutional Ethical Committee. Inclusion criteria were American Society of Anesthesiologists physical Status I-II and age between 18 and 50 years. Patients were randomly allocated to two groups of 30 patients each [group I (bupivacaine alone) and group II (bupivacaine + dexamethasone)]. Group I received 30ml of 0.5% bupivacaine with 2ml normal saline while group II received 30ml of 0.5% bupivacaine with 2ml (8mg) dexamethasone for supraclavicular brachial plexus block. Statistical analysis was performed with SPSS for Windows (SPSS Inc., Chicago, IL, USA), version 16.0. For analysis of demographic data and comparison of groups, χ2, unpaired Student's t-test and Mann-Whitney U-test were performed. Power of significance p-value of <0.05 was considered to be statistically significant. We evaluated onset, quality and duration of sensory and motor block along with side effects if any.Results: The mean onset of sensory and motor block in Group I and II was statistically insignificant. The duration of motor and sensory block was significantly prolonged in Group II than in Group I. There were no statistically and clinically significant differences in respiratory and hemodynamic parameters.Conclusions: We conclude that dexamethasone as an adjuvant in supraclavicular brachial plexus block prolongs the duration of motor and sensory block with insignificant side effects.

scholarly journals Đánh giá một số yếu tố tương quan ảnh hưởng đến gây tê đám rối thần kinh cánh tay trong phẫu thuật chi trên

2020 ◽  
Author(s):  
Văn Trí Nguyễn
Keyword(s):  
Brachial Plexus ◽  
Upper Limb ◽  
Motor Block ◽  
Brachial Plexus Block ◽  
Sensory Block ◽  
Strong Positive Correlation ◽  
Procedure Time ◽  
Group I ◽  
Group Ii ◽  
Plexus Block

EVALUATION OF SOME CORRELATIVE FACTORS AFFECTING TO BRACHIAL PLEXUS BLOCK IN UPPER LIMB SURGERIES Objective: To assess correlations between age and onset sensory block, age and duration of sensory block, the procedure time and BMI. As well as evaluating the degree of sensory and motor blockade. Subjects and methods: 120 patients underwent upper limb surgery in Hue Central Hospital from 5/2017 to 6/2018. Patients were divided into two groups, group I was 60 patients undergoing ultrasound-guided supraclavicular brachial plexus block, group II was 60 patients with nerve stimulor technique. Each group received 25ml levobupivacaine 0.5% and 1 / 200,000 adrenalin. Results: There were the strong positive correlation between the procedure time and BMI, age and duration of sensory block. There was an inverse correlation between age and onset sensory block. The procedure time was 9,82 ± 4,55 minutes in group I and 14,73 ± 4,73 minutes in group II (p < 0,05). The onset of sensory and motor block was 6,15 ± 1,60 minutes and 7,95 ± 1,05 minutes in group I and 9,92 ± 2,88 minutes and 12,63 ± 2,15 minutes respectively in group II (p < 0,05). The duration of sensory and motor block was 481,38± 116,66 minutes and 412,97 ± 107,32 minutes for group I and 319,22 ± 143,14 minutes and 205,88 ± 48,96 minutes respectively in group II. Conclusion: The procedure time and BMI, age and duration of sensory block, age and onset sensory block, all of them were strongly correlated. Ultrasound guidance for supraclavicular brachial plexus blockade provides a block that was faster in onset, longer duration of block. Key words: brachial plexus block, upper limb surgeries

“A COMPARATIVE STUDY OF ULTRASOUND GUIDED TECHNIQUE VERSUS PERIPHERAL NERVE STIMULATOR GUIDED TECHNIQUE IN INFRA-CLAVICULAR BRACHIAL PLEXUS BLOCK FOR UPPER LIMB SURGERIES.”

2021 ◽  
pp. 68-71
Author(s):  
Sonali M Khobragade ◽  
Roopa R
Keyword(s):  
Brachial Plexus ◽  
Success Rate ◽  
Upper Limb ◽  
Execution Time ◽  
Motor Block ◽  
Brachial Plexus Block ◽  
Motor Blockade ◽  
Ultrasound Guided ◽  
Sensory Blockade ◽  
Plexus Block

Background: Extensive use of ultrasonography for block execution has increased the success of procedure due to direct visualization of anatomical structures. Infra-clavicular brachial plexus block can be an attractive alternative to supraclavicular nerve block for upper limb surgeries. The objective of our study was to assess and compare the efcacy and success rate of USG guided technique versus PNS technique in Infra-clavicular brachial plexus block. Material And Methods: 70 adult patients with age in the range of 18-60 years, weight 50-80 Kg, ASA Grade I & II posted for elective upper limb surgeries of hand, wrist, forearm and distal arm under infra-clavicular brachial plexus block. Group P (PNS)– Nerve stimulator guided Infraclavicular brachial plexus block. Group U (USG)– Ultrasound guided Infraclavicular brachial plexus block. Block execution time, sensory blockade, motor blockade and success rate were assessed. Assessment of sensory blockade was done by Hollmen scale whereas motor block assessment was done by Bromage Scale. Results: There was statistically signicant difference between the groups for block execution time, onset of sensory and motor blockade, time for complete sensory and motor block and success rate(p<0.05). Conclusion: We conclude that, Ultrasound guided infraclavicular nerve block has shorter block execution time, faster sensory and motor block onset, signicantly earlier complete sensory and motor blockade, higher success rate with lesser pricks and minimal complications and should be preferred over PNS technique.

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 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 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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