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

scholarly journals A COMPARATIVE STUDY OF ROPIVACAINE VERSUS ROPIVACAINE WITH DEXMEDETOMIDINE AS AN ADJUVANT IN SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK

2021 ◽  
pp. 138-142
Author(s):  
Deba Gopal Pathak ◽  
Dipanjali Nath
Keyword(s):  
Side Effects ◽  
Brachial Plexus ◽  
Upper Limb ◽  
Local Anesthetic ◽  
Brachial Plexus Block ◽  
Onset Time ◽  
Sensory Blockade ◽  
Suitable Alternative ◽  
Supraclavicular Brachial Plexus Block ◽  
Plexus Block

BACKGROUND : Supraclavicular approach to brachial plexus block is a versatile and reliable regional anesthesia technique and a suitable alternative to general anesthesia for upper limb surgical procedures. Ropivacaine , a long acting local anesthetic, with less tendency for neurotoxicity and cardiotoxicity is a great local anesthetic for the procedure. Use of adjuvant Dexmedetomidine , a potent alpha 2 adrenoreceptor agonist improves the quality of anesthesia as well as intra-operative and post-operative analgesia while maintaining haemodynamic stability, arousable sedation and mild respiratory depression. MATERIALS AND METHODS: Eighty patients aged between 18 and 60 years with ASA grade I or II posted for elective upper limb surgeries were included in the study and were randomly divided into 2 groups with forty patients in each. Group A received 0.5% ropivacaine (31 mL) and Group B received 0.5% ropivacaine + dexmedetomidine 1microgram/kg (31mL). Both groups were compared for onset time and duration of sensory blockade, onset time and duration of motor blockade , total duration of analgesia and associated side effects. CONCLUSION : Dexmedetomidine as an adjuvant to ropivacaine in the supraclavicular brachial plexus block for upper limb surgeries , significantly shortens the onset time and prolongs the duration of sensory and motor blocks, with longer duration of post-operative analgesia , with associated significant sedation and a few manageable side effects like bradycardia and hypotension.

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

scholarly journals COMPARISON OF FENTANYL AND DEXMEDETOMIDINE AS AN ADJUVANT TO BUPIVACAINE IN SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK: A RANDOMIZED-DOUBLE BLIND PROSPECTIVE STUDY

2016 ◽  
Vol 9 (5) ◽  
pp. 74 ◽  
Author(s):  
Daisy Karan ◽  
Swastika Swaro ◽  
Swarna Banerjee
Keyword(s):  
Brachial Plexus ◽  
Upper Limb ◽  
Brachial Plexus Block ◽  
Nerve Blocks ◽  
Double Blind ◽  
Rescue Analgesia ◽  
Sensory Blockade ◽  
Significant Difference ◽  
Supraclavicular Brachial Plexus Block ◽  
Plexus Block

ABSTRACTObjectives: Supraclavicular block of brachial plexus provides complete and reliable anesthesia for upper limb surgeries. Using adjuvant to localanesthetics, blocks can be prolonged to long durations. Peripheral nerve blocks thus help in avoiding the hazards of general anesthesia. We comparedthe sensory blockade, motor blockade, and duration of analgesia with the addition of fentanyl or dexmedetomidine to bupivacaine for supraclavicularbrachial plexus block.Methods: A total of 50 American Society of Anesthesiologist’s Physical Status I and II patients scheduled for elective upper limb surgeries undersupraclavicular brachial plexus block were divided into two equal groups in a randomized double-blinded fashion. Group BF received 30 mlbupivacaine with fentanyl 50 µg and Group BD received 30 ml bupivacaine with dexmedetomidine 50 µg. The characteristics for anesthesia andanalgesia were assessed in both groups.Results: Duration of sensory and motor block was 363.4±38.36 minutes and 357±36.77 minutes, respectively, in Group BF while it was452.96±77.12 minutes and 441.52±48.46 minutes in Group BD. There was a statistically significant difference in onset of sensory and motorblock between the two groups. The duration of analgesia (time to requirement of rescue analgesia) in Group BD was longer than in Group BF(471.44±65.88 minutes vs. 366.48±38.02 minutes) with (p<0.0001). There were minimum hemodynamic disturbances and side effects in any groupexcept for Grade 3 sedation score which was more in Group BD.Conclusion: Dexmedetomidine, when added to bupivacaine in supraclavicular brachial plexus block, enhanced the duration of sensory and motorblock and also the duration of analgesia, more than when fentanyl was added to bupivacaine.Keywords: Fentanyl, Dexmedetomidine, Bupivacaine, Supraclavicular brachial block.

scholarly journals Ultrasound Guided Axillary Brachial Plexus Block Versus Supraclavicular Block In Emergency Crushed Hand Patients : A Comparative Study

2018 ◽  
Vol 12 (1) ◽  
pp. 34-41
Author(s):  
Rania Maher Hussien ◽  
Dalia Ahmed Ibrahim
Keyword(s):  
Brachial Plexus ◽  
Brachial Plexus Block ◽  
Onset Time ◽  
Hand Surgery ◽  
Good Alternative ◽  
Ultrasound Guided ◽  
Performance Time ◽  
Needle Pass ◽  
Supraclavicular Block ◽  
Plexus Block

Background: The current study focusses on ultrasound guided Brachial Plexus Block (BPB) which plays an important role in patients with hand trauma either in pain control or for surgical intervention. The brachial plexus can be blocked by several techniques but the most commonly used are the Supraclavicular (SCB) and Axillary (AXB) blocks. Objective: To compare the two techniques with regards to the performance time, needling time, anesthesia-related time, block-related complications, number of needle pass and block related pain. Methods: After approval of the ethical committee and obtaining a written informed consent from patients, this prospective, randomized, interventional double-blinded study was done to patients undergoing emergency crushed hand surgery. 80 patients were allocated randomly into two equal groups. Under ultrasound guidance, the SCB and AXB were done for the two groups, respectively. The needling time, performance time, anesthesia-related time, onset time, number of 1st needle pass in each group and block related complications were noted. Statistical Analysis: Data were analysed using the Statistical Package for Social Science (IBM SPSS) version 23 SPSS. Results: Longer needling, performance, anesthesia-related time in the AXB group than SCB and less complications have occurred with AXB than SCB group. Conclusion: Axillary block of brachial plexus is a good alternative to Supraclavicular block in emergency crushed hand surgery and the choice is made according to the requirement of each case.

scholarly journals Hoarseness of Voice following Left Supraclavicular Brachial Plexus Block: A Case Report

2021 ◽  
Vol 59 (241) ◽  
pp. 925-928
Author(s):  
Subin Shrestha ◽  
Sadikshya Regmi ◽  
Gopendra Deo ◽  
Indra Narayan Shrestha
Keyword(s):  
Brachial Plexus ◽  
Recurrent Laryngeal Nerve ◽  
Brachial Plexus Block ◽  
Rare Complication ◽  
Local Anaesthetics ◽  
Laryngeal Nerve ◽  
Ultrasound Guided ◽  
Supraclavicular Brachial Plexus Block ◽  
Supraclavicular Block ◽  
Plexus Block

Supraclavicular brachial plexus block is extensively used for primary regional anaesthesia as well as postoperative analgesia for the surgical procedures of the upper limb. The evidence for the use of ultrasound in supraclavicular brachial plexus is growing day by day as it has the advantage of allowing real time visualisation of the plexus, pleura and vessels along with the needle and local anaesthetics spread. Despite this, complications can even arise with ultrasound guided supraclavicular brachial plexus block. Hoarseness of voice due to recurrent laryngeal nerve block is a rare complication of supraclavicular brachial plexus block. There are few reported cases of hoarseness of voice following the right supraclavicular block. There is only one reported case of hoarseness of voice following the left supraclavicular block. Here, we report a case of a 16-year-old boy who developed hoarseness of voice due to left recurrent laryngeal nerve following ultrasound guided left supraclavicular brachialplexus block.

SUPRACLAVICAL BRACHIAL PLEXUS BLOCK WITH A NERVE STIMULATOR FOR FOREARM SURGERY

2017 ◽  
pp. 113-118
Author(s):  
Van Minh Nguyen ◽  
Thi Minh Thu Pham
Keyword(s):  
Side Effects ◽  
Brachial Plexus ◽  
Brachial Plexus Block ◽  
Onset Time ◽  
Procedure Time ◽  
Nerve Stimulator ◽  
Time Duration ◽  
Duration Of Action ◽  
Supraclavicular Brachial Plexus Block ◽  
Plexus Block

Objective: To evaluate the effectiveness, side effects and complications of supraclavicular brachial plexus block with a nerve stimulator for forearm surgery. Materials and Method: In a prospective descriptive study, forty patients received supraclavicular brachial plexus block for forearm surgery. The dose was 7 mg/kg of 1% lidocaine mixed with adrenaline 1:200000. Success of technique, procedure time, onset time, duration of action, minimum current, side effects and complication were recorded. Results: The success rate was 85% (including 17.5% of patients needed small amount of fentanyl or/and local anesthetic), failure rate was 15%. The procedure time 7.70 ± 5.75 min, onset time 7.62 ± 5.09 min, duration time 172.94 ± 74.85 min. The minimal stimulating current of the nerve location was 0.54 0.12 mA. There were 2.5% with hoarseness of voice and 7.5% with blood vessel puncture. Conclusion: Supraclavicular brachial plexus block with a nerve stimulator for forearm surgery was an effective anesthetic technique with a low rate of side effects and complications. Key words: supraclavicular brachial plexus block, nerve stimulator

scholarly journals Effect of Addition of Dexamethasone to Local Anaesthetics in Supraclavicular Brachial Plexus Block

1970 ◽  
Vol 7 (1) ◽  
pp. 11-14 ◽  
Author(s):  
SM Islam ◽  
MHMD Hossain ◽  
AA Maruf
Keyword(s):  
Brachial Plexus ◽  
Motor Block ◽  
Brachial Plexus Block ◽  
Onset Time ◽  
Local Anaesthetics ◽  
Prolonged Duration ◽  
Supraclavicular Brachial Plexus Block ◽  
Group A ◽  
Group B ◽  
Plexus Block

Introduction: Many-a-time local anaesthesia appears as a very effective alternative of general one. Different additives have been used to prolong regional blockade. Objective: This prospective study designed to evaluate the effect of dexamethasone added to local anaesthetics on the onset and duration of supraclavicular brachial plexus block. Methods: Sixty adult patients undergoing various orthopaedic surgeries on forearm and around the elbow under supraclavicular brachial plexus block were selected and divided into 2 groups of 30 each. In group-A patients received 35 ml of mixture of lignocaine 2%, bupivacaine 0.5% while in group-B patients received the same amount of local anaesthetics with dexamethasone (8 mg). The onset of sensory and motor block and duration of analgesia in two groups were compared and development of complications were observed. Result: The two groups were comparable in demographic data. The mean onset time of sensory block was 11.64±2.19 minutes in group A and 9.89±1.97 minutes in group B and difference was statistically significant (p<0.05). Onset of motor block was 13.32±0.98 minutes in group A and 11.09±1.28 minutes in group B and difference was statistically significant (p<0.05). There was markedly prolonged duration of analgesia in group-B, 11.87± 0.53 hours compared to group-A, 3.43±0.49 hours. The result was statistically highly significant (p<0.001). Both the groups had high success rate (>90%). The incidence of complication was low in both the groups. Conclusion: Addition of dexamethasone as an adjuvant to local anaesthetics in brachial plexus block results in significantly early onset and markedly prolonged duration of analgesia without any unwanted effects. Key words: Supraclavicular block; analgesia; local anaesthetics; dexamethasone DOI: http://dx.doi.org/10.3329/jafmc.v7i1.8619 JAFMC Bangladesh. Vol 7, No 1 (June) 2011; 11-14

scholarly journals ASSESSMENT OF ANALGESIC EFFICACY OF CLONIDINE AND FENTANYL WITH ROPIVACAINE IN THE SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK

2018 ◽  
Author(s):  
Krishna Kumar
Keyword(s):  
Brachial Plexus ◽  
Brachial Plexus Block ◽  
Analgesic Efficacy ◽  
Systemic Absorption ◽  
Duration Of Action ◽  
C Fibers ◽  
Regional Nerve Block ◽  
Supraclavicular Brachial Plexus Block ◽  
Supraclavicular Block ◽  
Plexus Block

Ropivacaine, the S (-) enantiomer of N-(2,6- dimethylphenyl)-1-propyl-2-piperidinecarboxamide is a new long-acting local anesthetic like bupivacaine. Ropivacaine, compared to bupivacaine blocks pain transmitting A-delta and C fibers to a greater extent than A-beta fibers (controlling motor function). Ropivacaine has a wider margin of safety and is less cardiac & neurotoxic compared to bupivacaine with similar duration of action. The fentanyl and clonidine given with local anaesthetic in regional nerve block enhances the block by acting perineurally or it is because of systemic absorption of fentanyl and clonidine administered in block. The current study was planned to compare the efficacy of fentanyl and clonidine as an adjuvants and as an intravenous administration in supraclavicular plexus block with 0.75% ropivacaine. The study was planned in the Department of the Surgery undergoing the Anaesthesia in  Sri  Krishna  Medical  College  and  Hospital,  Muzaffarpur, from Jan 2017 to Jun 2017. After obtaining proper informed consent, 40 adult patients of both sexes, aged 18 to 65 years, belonging to ASA I or II and undergoing supraclavicular brachial plexus block were enrolled for this study. The data from the [resent study concludes that the arliest onset of sensory and motor blockade as well as longer duration of analgesia resulted when clonidine 150 µg was used as a perineural adjuvant to Ropivacane 0.75% with minimal side effects compared to its same dose given intravenously. Keywords: supraclavicular  block, clonidine, fentanyl , ropivacaine, etc.

scholarly journals Dexamethasone with Local Anesthetics Versus Local Anesthetics Alone in Supraclavicular Brachial Plexus Block in Upper Limb Surgeries

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
A N Elshaer ◽  
S G A Said ◽  
D S Alawady ◽  
A M Reyad
Keyword(s):  
Brachial Plexus ◽  
Nerve Block ◽  
Local Anesthetics ◽  
Brachial Plexus Block ◽  
Sensory Block ◽  
Control Group ◽  
Nerve Blocks ◽  
Supraclavicular Brachial Plexus Block ◽  
Prolonged Hospital ◽  
Plexus Block

Abstract Background Poorly controlled acute pain after surgery is associated with a variety of unwanted postoperative consequences, including patient suffering, distress, myocardial ischemia, prolonged hospital stays and an increased likelihood of chronic pain. Systemic analgesics (opioids and non-opioids) have long been used for postoperative pain, then neuroaxial or peripheral nerve blocks were employed. Local anesthetics alone were used, then various adjuvants were added to achieve quick, dense and prolonged block. Objective The aim of this study was to study the effect of dexamethasone as an adjuvant to bupivacaine in supraclavicular brachial plexus block. The comparison included the onset and the duration of the sensory and motor blocks, the duration of analgesia of the block as well as their effects on the postoperative analgesic requirements. The effect of the drugs on hemodynamics and monitoring the occurrence of any complication were also done. Patients and Methods In our study, 60 patients were randomly divided into 2 equal groups. Control group received bupivacaine only (0.5%) and dexa group in which 8 mg of dexamethasone were added to bupivacaine. All patients received equal volumes of 20 milliliters. Results Our study showed that addition of 8 milligrams of dexamethasone to bupivacaine in ultrasound-guided supraclavicular nerve block shortened the onset times of motor blocks and significantly prolonged motor and sensory block durations. In addition, dexamethasone prolonged the duration of analgesia of the plexus block significantly, as proved by the time of request of analgesia. Moreover, in dexa group, postoperative analgesic requirements were greatly lesser than that of bupivacaine groups. Addition of dexamethasone also did not affect the hemodynamics to a significant level. This makes dexamethasone with bupivacaine more superior than the use of bupivacaine alone. Conclusion Addition of dexamethasone to bupivacaine in supraclavicular nerve block shortened the onset motor blocks. Addition of dexamethasone to bupivacaine significantly prolongs of both sensory and motor block durations.

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