scholarly journals A PROSPECTIVE, RANDOMIZED, DOUBLE BLINDED, CONTROLLED STUDY TO EVALUATE THE EFFICACY OF DEXMEDETOMIDINE 50µg AND DEXAMETHASONE 8mg AS AN ADJUVANT TO ROPIVACAINE 0.5% FOR SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK IN ELECTIVE UPPER LIMB SURGERIES.

2020 ◽  
pp. 63-65
Author(s):  
Kavya Madhyastha ◽  
Shashikala T K
Keyword(s):  
Brachial Plexus ◽  
Upper Limb ◽  
Motor Block ◽  
Total Duration ◽  
Saline Group ◽  
Primary Objective ◽  
Controlled Study ◽  
Supraclavicular Brachial Plexus Block ◽  
Double Blinded ◽  
Plexus Block

BACKGROUND: Brachial Plexus Blocks are the popular choice of anaesthesia technique as a part of day care surgeries for upper limb. In this study, efficacy of non opioid adjuvants Dexamethasone and Dexmedetomidine has been evaluated. MATERIALS AND METHODS: 90 ASA class I and II patients undergoing elective upper limb surgeries were randomly divided into three groups of 30 each. Group C received 0.5% Ropivacaine 28ml with 2ml normal saline, Group DX received 0.5% Ropivacaine 28ml with 8mg Dexamethasone and Group DM received 0.5% Ropivacaine 28ml with Dexmedetomidine 50µg. The primary objective was to know the sensory and motor block onset, total sensory and motor block duration, total duration of analgesia. Secondary parameters were mean arterial pressure, peripheral saturation and sedation score. Statistical methods were carried out through SPSS for Windows(version 16.0) RESULTS: The sensory and motor block onset was earlier in Group DM compared to Group C and Group DX, while it was later in Group DX compared to Group C. The mean TSBD, TMBD and TDA was longer in Group DX(746.66min, 677.83min, 800.16min) compared to Group C (361.33min, 303.66min, 411.16min)and Group DM(686.33min, 593.5 min, 701.83min). There was no significant change in MAP, SpO2 and sedation scores.

scholarly journals Comparative study of ropivacaine alone versus ropivacaine with dexamethasone in supraclavicular brachial plexus block

2017 ◽  
Vol 4 (12) ◽  
pp. 3879 ◽  
Author(s):  
Sampathi Shiva Krishna ◽  
G. Praveen Chandra ◽  
C. Krishna Chaithanya
Keyword(s):  
Brachial Plexus ◽  
Upper Limb ◽  
Motor Block ◽  
Statistical Difference ◽  
Brachial Plexus Block ◽  
Total Duration ◽  
Duration Of Surgery ◽  
Supraclavicular Brachial Plexus Block ◽  
Plexus Block ◽  
Very High

Background: Brachial plexus block is often used either as an adjuvant to general anesthesia (GA) or as a sole anesthesia modality. Supraclavicular brachial plexus block is preferred for its rapid onset, reliable anesthesia and as a safe technique for any surgery in the upper extremity that does not involve the shoulder. We have attempted to undertake this study to compare the haemodynamic, sensory and motor effects of the anaesthetic effect of Ropivacaine alone and Ropivacaine along with Dexamethasone in Supraclavicular Brachial Block in upper limb surgery.Methods: The total duration of surgery was also comparable in both groups. The onset of the sensory and the motor block in bother the groups were similar to each other with no statistical difference, but there was a very high significance in the duration of both sensory and motor block within both the groups.Results: The total duration of surgery was also comparable in both groups. The onset of the sensory and the motor block in bother the groups were similar to each other with no statistical difference, but there was a very high significance in the duration of both sensory and motor block within both the groups.Conclusions: Dexamethasone added to ropivacaine in supraclavicular brachial block for upper limb surgery significantly shortens the onset time and prolongs the duration of sensory and motor blocks without producing sedation in patients.

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 Effect of dexamethasone as an adjuvant to 0.5% levobupivacaine in supraclavicular brachial plexus block for upper extremity surgeries

2017 ◽  
Vol 5 (5) ◽  
pp. 1943 ◽  
Author(s):  
Kartheek Hanumansetty ◽  
Hemalatha S. ◽  
Gurudatt C. L.
Keyword(s):  
Brachial Plexus ◽  
Upper Extremity ◽  
Upper Limb ◽  
Postoperative Analgesia ◽  
Motor Block ◽  
Brachial Plexus Block ◽  
Peak Effect ◽  
Motor Blockade ◽  
Supraclavicular Brachial Plexus Block ◽  
Plexus Block

Background: The supraclavicular brachial plexus block has proven to be an important, safer and effective alternative to general anaesthesia in surgeries of upper extremity. Primary aim is to study the effect of addition of dexamethasone to levobupivacaine on postoperative analgesia and secondary objectives are to study onset, peak effect and duration of sensory and motor block in brachial plexus blockade in adult patients posted for upper limb surgeriesMethods: This prospective randomized clinical study was conducted on 60 patients of age 18 to 60 years posted for upper limb surgeries. They were randomly allocated into two groups of 30. In Control group LS (n=30) received Inj. Levobupivacaine 30ml and Inj. Normal saline 2ml. In Study group LD (n=30) received Inj. Levobupivacaine 30ml and Inj. Dexamethasone 2ml (8mg).Results: Both the groups were demographically comparable. Onset of sensory block and motor block in group LD and in group LS were similar (p>0.05). Mean duration of sensory and motor block in group LD was higher than in group LS (<0.001). Duration of postoperative analgesia was 21.20±3.23 hours in group LD and 10.24±1.57 hours in group LS (p<0.001).Conclusions: Dexamethasone added to levobupivacaine for brachial plexus block prolonged the duration of sensory, motor blockade and postoperative analgesia but did not alter the onset time, peak effect time of sensory and motor blockade.

scholarly journals A CLINICAL COMPARISON OF 0.75% ISOBARIC ROPIVACAINE WITH 0.5% ISOBARIC BUPIVACAINE IN SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK FOR UPPER LIMB SURGERIES

2020 ◽  
pp. 43-46
Author(s):  
Kalyan Sarma ◽  
Bandana Mahanta ◽  
Prabir Pranjal Das
Keyword(s):  
Brachial Plexus ◽  
Upper Limb ◽  
Motor Block ◽  
Brachial Plexus Block ◽  
Sensory Block ◽  
Motor Blockade ◽  
Supraclavicular Brachial Plexus Block ◽  
The Mean ◽  
Group B ◽  
Plexus Block

Background: Regional anaesthesia and analgesia, has the potential to provide excellent operating conditions along with better and prolonged post-operative with pain relief with fewer side effects. As a result, it is becoming increasingly popular for ambulatory anaesthesia and for day care patients.. Among the commonly used local anaesthetics, lignocaine and bupivacaine, bupivacaine has significant cardiovascular and central nervous system toxicity. In addition, bupivacaine also has lesser differentiation between sensory and motor blockade post-operatively. Ropivacaine and levobupivacaine were developed to avoid the bupivacaine related toxicities. The clinical safety profile of ropivacaine seems to be more favourable than that of levobupivacaine. With this background the following study was conducted to evaluate the efficacy of ropivacaine 0.75% for brachial plexus block in upper limb surgeries and its clinical comparison with bupivacaine 0.5%. Aims and Objectives: To assess the efficacy and toxicity of ropivacaine 0.75% and bupivacaine 0.5% as potential agents for brachial plexus block for surgeries of the upper limb around and below the elbow. Settings and Design: prospective, comparative, randomized, single blinded clinical trial. Materials and Methods: After institutional ethical committee approval, 100 patients physical status ASA I & II, of either sex, between 18-60 years, weighing between 40-60 kgs posted for upper limb surgeries around the elbow, forearm and hand were divide into two groups of 50 patients each. Group R (Ropivacaine group) received 0.75% isobaric ropivacaine 30 ml in supraclavicular brachial plexus block. Group B (Bupivacaine group) received 0.5% isobaric bupivacaine 30 ml in supraclavicular brachial plexus block by using peripheral nerve stimulator. Vitals, sensory, motor and analgesia score at pre-defined intervals intra-operatively were noted. Onset of analgesia, sensory & motor blockade, total duration of post-operative pain relief (VAS ≥ 5) and time of demand of first rescue analgesic were also noted along with any intra-operative complications, if any. Statistical Analysis: All the results were expressed as Mean ± SD. Statistical analysis was performed using Unpaired Student’s t-Test. Statistical significance was considered with a p value of ≤ 0.05. Results: Demographic profile and duration of surgery were comparable among the two groups. The mean time of onset of sensory block, onset of motor block and onset of analgesia were significant (p<0.05) in group R as compared to group B. The mean duration of sensory block and duration of post-operative analgesia were comparable between the two groups. However, the mean duration of motor block was significantly lower (p<0.05) in group R as compared to group B. the baseline hemodynamic variables and requirement of first analgesic dose and other adverse events were equivalent in both the group. Conclusion: Ropivacaine when compared with Bupivacaine, has faster onset of analgesia, sensory & motor blockade, significantly lesser duration of motor blockade. Ropivacaine also provides satisfactory post-operative analgesia with a stable hemodynamic profile similar to Bupivacaine with no undue adverse effects.

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 Comparison of Levobupivacaine and Levobupivacaine with Dexmedetomidine for Supraclavicular Brachial Plexus Block in Patients Undergoing Upper Limb Surgeries-A Randomised Controlled Trial

2021 ◽  
Author(s):  
Balraj Hariharasudhan ◽  
Sridhar Savithasree ◽  
Rajesh S Mane ◽  
S Sivakumar ◽  
BT Arish
Keyword(s):  
Brachial Plexus ◽  
Upper Limb ◽  
Regional Anaesthesia ◽  
Brachial Plexus Block ◽  
Controlled Study ◽  
Motor Blockade ◽  
Supraclavicular Brachial Plexus Block ◽  
Randomised Controlled ◽  
Regional Anaesthetic Technique ◽  
Plexus Block

Introduction: Brachial plexus blockade at the supraclavicular level delivers an excellent regional anaesthetic technique with unmatched effectiveness for upper limb surgeries. Levobupivacaine, a safer alternative to the commonly used bupivacaine for regional anaesthesia and addition of α2-agonists like dexmedetomidine further improves the quality of regional anaesthesia. Aim: To evaluate the efficacy of levobupivacaine in combination with dexmedetomidine for supraclavicular brachial plexus block. Materials and Methods: This randomised controlled study enrolled 50 American Society of Anaesthesiologist (ASA) grade I and II patients aged between 18-60 years posted for elective upper limb surgeries. Randomisation was done and the patients were divided into two groups with 25 each, to receive either 39 mL of 0.5% levobupivacaine and 100 μgs (1 mL) of dexmedetomidine in group LD (Levobupivacaine with Dexmedetomidine) and 39 mL of 0.5% levobupivacaine and 1 mL of normal saline in group LS (Levobupivacaine with Saline). The onset and duration of sensory and motor blockade along with duration of analgesia were observed. All Quantitative data were compared and analysed using student’s unpaired t test while qualitative data were analysed using Chi-square test. A p-value of less than 0.05 was considered to be statistically significant. Results: The onset of sensory and motor blockade in group LD was significantly faster when compared to group LS (p<0.001). group LD had a longer mean duration of sensory and motor blockade along with duration of analgesia when compared to group LS (p<0.001). There was a better hemodynamic stability in group LD when compared to group LS. Conclusion: Dexmedetomidine added to levobupivacaine provides significantly shorter onset times, greatly prolongs the duration of sensory and motor blockade along with duration of analgesia without any systemic side effects.

Sign in / Sign up

Export Citation Format

Share Document