A Randomized, Prospective, Double-Blind Trial Comparing 3% Chloroprocaine Followed by 0.5% Bupivacaine to 2% Lidocaine Followed by 0.5% Bupivacaine for Interscalene Brachial Plexus Block

2008 ◽  
Vol 107 (5) ◽  
pp. 1746-1750 ◽  
Author(s):  
Soheila Jafari ◽  
Allison I. Kalstein ◽  
Habib M. Nasrullah ◽  
Mehrdad Hedayatnia ◽  
Joel M. Yarmush ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Brachial Plexus Block ◽  
Double Blind Trial ◽  
Double Blind ◽  
Interscalene Brachial Plexus Block ◽  
Blind Trial ◽  
Plexus Block

TO STUDY AND COMPARE THE EFFECT OF DEXMEDETOMIDINE AND FENTANY AS AN ADJUVANT TO LEVOBUPIVACAINE IN INTERSCALENE BRACHIAL PLEXUS BLOCK FOR HUMERUS SURGERY: A PROSPECTIVE RANDOMIZED DOUBLE-BLIND CONTROLLED STUDY

2020 ◽  
Vol 4 (7) ◽  
Author(s):  
Kushal Jethani ◽  
Khushboo . ◽  
Anjali Bansal
Keyword(s):  
Brachial Plexus ◽  
Postoperative Analgesia ◽  
Motor Block ◽  
Brachial Plexus Block ◽  
Controlled Study ◽  
Double Blind ◽  
Interscalene Brachial Plexus Block ◽  
The Mean ◽  
Plexus Block ◽  
Group D

Introduction: Interscalene brachial plexus block provides complete and reliable anaesthesia for surgery of humerus as well as analgesia for postoperative period. Many studies are being done for the search for an adjuvant which when added to a local anaesthetic, prolong the duration of postoperative analgesia. Therefore we compared the effect of fentanyl and dexmedetomidine on postoperative analgesia when added to levobupivacaine for Interscalene brachial plexus block. Material and Methods: In this prospective study, 90 patients were randomly allocated to 3 groups:  Group C (n=30) recieved 30 ml of 0.5% levobupivacaine, Group D (n=30) recieved 30 ml of 0.5% levobupivacaine + dexmedetomidine 1 μg/kg, Group F (n=30) recieved 30 ml of 0.5% levobupivacaine + fentanyl 1 μg/kg. The duration of blockade and analgesia were assessed for all the three groups. Observations: Demographic profile was comparable in all the groups. The onset of sensory and motor block and duration of analgesia and motor block were enhanced in Group D and Group F as compared to Group C. The mean pulse rate and mean arterial pressure were slightly lower in dexmedetomidine group than in other two groups. Results: Compared to the use of levobupivacaine alone for interscalene brachial plexus block, addition of 1 mcg/kg dexmedetomidine or 1 mcg/kg fentanyl to levobupivacaine enhanced the onset of blockade as well as increased the duration of blockade and post-operative analgesia. Also, the blockade characteristics were better improved with addition of dexmedetomidine to levobupivacaine than addition of fentanyl to levobupivacaine without increasing incidence of any unwanted side-effects. Keywords: Interscalene brachial plexus block, Levobupivacaine, Fentanyl, Dexmedetomidine.

scholarly journals Diaphragmatic paralysis, respiratory function, and postoperative pain after interscalene brachial plexus block with a reduced dose of 10 ml levobupivacaine 0.25% versus a 20 ml dose in patients undergoing arthroscopic shoulder surgery: study protocol for the randomized controlled double-blind REDOLEV study

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
P. Oliver-Fornies ◽  
J. P. Ortega Lahuerta ◽  
R. Gomez Gomez ◽  
I. Gonzalo Pellicer ◽  
L. Oliden Gutierrez ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Brachial Plexus ◽  
Brachial Plexus Block ◽  
Shoulder Surgery ◽  
Double Blind ◽  
Interscalene Brachial Plexus Block ◽  
Randomized Controlled ◽  
Arthroscopic Shoulder Surgery ◽  
Low Volume ◽  
Plexus Block

Abstract Background Arthroscopic shoulder surgery causes severe postoperative pain. An interscalene brachial plexus block provides adequate analgesia, but unintended spread of the local anesthetic administered may result in a phrenic nerve block, usually associated with a nonnegligible incidence of acute hemidiaphragmatic paralysis. The main purpose of this trial will be to analyze the incidence of hemidiaphragmatic paralysis ensuing after interscalene brachial plexus block in patients undergoing arthroscopic shoulder surgery administered a standard volume (20 ml) vs. a low volume (10 ml) of levobupivacaine 0.25%. Methods This will be a prospective double-blind randomized controlled single-center two-arm comparative trial. Forty-eight patients will be included. The primary goal will be to ultrasonographically determine the incidence of hemidiaphragmatic paralysis by calculating the diaphragmatic thickness ratio in each group. The secondary goals will be to compare the two arms in terms of (1) decrease in forced vital capacity and (2) in forced expiratory volume at 1 s by spirometry; (3) decrease in diaphragmatic excursion by ultrasound; (4) 24-h total intravenous morphine consumption; (5) time to first opioid request of a patient-controlled analgesia pump; and (6) postoperative complications. Discussion This trial will demonstrate that a low-volume interscalene brachial plexus block decreases hemidiaphragmatic paralysis following arthroscopic shoulder surgery according to spirometry and ultrasound measurements and does not provide inferior postoperative analgesia to the standard volume, as measured by opioid requirements. Trial registration EudraCT and Spanish Trial Register (REec) registration number: 2019-003855-12 (registered on 7 January 2020). ClinicalTrials.gov identification number: NCT04385966 (retrospectively registered on 8 May 2020). Ethics Committee approval: EC19/093 (18 December 2019).

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