scholarly journals Infraclavicular Brachial plexus block in upper limb surgeries with local anaesthetic agent and dexmedetomidine as adjuvant for improving quality of analgesia

2018 ◽  
Vol 7 (1) ◽  
pp. 4
Author(s):  
Feny Thakkar ◽  
Vandana Parmar ◽  
Vrinda Oza ◽  
Shilpa Sarathy
2021 ◽  
Vol 10 (24) ◽  
pp. 1825-1829
Author(s):  
Amol Singam ◽  
Punith M. Sirige

BACKGROUND Regional anaesthesia has multiple advantages as compared to general anaesthesia for upper limb surgeries. Here in this study, we wanted to compare bupivacaine 0.5 %, commonly used anaesthetic with ropivacaine 0.75 % which has fewer side effects like cardiotoxicity for supraclavicular brachial plexus block. METHODS A study was performed on 60 ASA I & II patients aged between 18 and 75 years, undergoing upper limb elective surgeries under brachial plexus block using nerve locator. Beginning of sensory and motor block, general nature of block, and terms of sensory and motor blocks were assessed in the C5 to T1 dermatomes. RESULTS There was no statistically significant difference in the onset of sensory and motor blockade between ropivacaine 0.75 % and bupivacaine 0.5 %. Ropivacaine 0.75 % produced similar quality of motor and sensory blockade compared to 0.5 % bupivacaine. The time taken for maximum motor blockade with ropivacaine was comparable with that of bupivacaine 0.5 %. There was no statistically significant difference regarding the duration of analgesia with ropivacaine 0.75 % compared to bupivacaine 0.5 %. Duration of motor blockade with 0.75 % ropivacaine was comparable to that of 0.5 % bupivacaine. CONCLUSIONS Ropivacaine 0.75 % 0.4 ml / kg or 0.5 % bupivacaine 0.4 ml / kg for supraclavicular brachial plexus block produces satisfactory and comparable sensory and motor blockade. It is suggested that lower cardiovascular toxicity of ropivacaine with equal efficacy as bupivacaine in such circumstances may help in reducing the risks to the patient. KEY WORDS Bupivacaine 0.5 %, Ropivacaine 0.75 %, Brachial Plexus Block, Upper Limb Orthopaedic Surgeries


2017 ◽  
Vol 13 (2) ◽  
pp. 13-16 ◽  
Author(s):  
Nabin Kumar Regmi ◽  
Sangeeta Subba ◽  
Uttam Chandra Sharma

Background: In peripheral nerve blocks, adjuvants are added to local anaesthetics to improve the quality of anaesthesia and analgesia. We designed this randomized single blinded prospective study to compare the analgesic efficacy of tramadol used as an adjuvant to bupivacaine for supraclavicular brachial plexus block in patients undergoing orthopaedic surgeries of upper limb.Aim of study: In this study, we aimed to compare onset, duration and quality of analgesia along with respiratory, hemodynamic changes with tramadol as adjuvant to bupivacaine in supraclavicular brachial plexus block in the patients undergoing upper limb surgery.Method: In this prospective randomized control trial, two groups of 30 patients each were investigated. 28 ml. of 0.5% bupivacaine (plain) with 2 ml. normal saline was administered in group - I and 28 ml. of 0.5% bupivacaine (plain) with 2ml. (100 mg.) tramadol was administered in group - II. The onset of sensory and motor block, duration of analgesia, respiratory/hemodynamic parameters and post-operatively quality of analgesia via visual analogue scale were assessed.Results: The duration and quality of analgesia was significantly increased by adding tramadol in bupivacaine than bupivacaine alone (p=<0.001 and <0.001) whereas there was no statistically significant difference in onset of motor (p=>0.35) and sensory block (p=>0.75) and also hemodynamic and respiratory parameters.(HR p=>0.1, MAP p=>0.5, and SPO p=>0.5).Conclusion: The study suggests that tramadol when added to bupivacaine 2 for supraclavicular brachial plexus block enhances the quality of anaesthesia and analgesia without affecting respiratory/hemodynamic parameters.JNGMC Vol. 13 No. 2 December 2015, Page: 13-16


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