Abstract
Background Articaine has been used in many dental and ophthalmic outpatient procedures. In the era of ultrasound-guided regional techniques, we searched for short and potent local anesthetic for patients undergoing ambulatory upper limb procedures. However, studies about articaine efficacy in brachial plexus block are limited. In this study, we compared its safety and efficacy against bupivacaine as a commonly used anesthetic agent for ultrasound-guided supraclavicular brachial plexus block. Methods This randomized prospective study was performed at Ain Shams University Hospital from January to March 2020. A total of 117 patients aged 20 to 60 years, with the American Society of Anesthesiologists physical status I and II, were enrolled in the study. Patients were randomly allocated into two groups: in group A, patients received 30 ml articaine 2%, and in group B, patients received 30 ml of bupivacaine 0.5%. We measured motor and sensory block duration as a primary outcome. Other secondary outcomes such as onset of block, duration of analgesia, patient satisfaction, and time to home discharge readiness were also measured. Results We analyzed data collected from 97 patients. The motor block duration was significantly shorter in group A (165.73 ± 20.33 min) than in group B (220.27 ± 37.73 min). The onset of motor block was faster in group A (8.73 ± 4.33 min), and the postoperative VAS score was lower in group B. Patients in group A achieved an earlier home discharge of 289.67 ± 2.73 min. Conclusion Earlier resolution of articaine block makes it more favorable than bupivacaine for ambulatory surgery. This trial is registered with (NCT04189198).
Highlights
Revolution in the surgical plane, advances in anesthetic techniques, and availability of new drugs, over the last 40 years, have led to a large switch to day-case surgery throughout the world [1]
Ultrasound-guided regional anesthesia plays a vital role in overcoming the limitations of general anesthesia, and supraclavicular brachial plexus block (SBPB) is used safely for both urgent and scheduled surgeries of the upper limb on a day-case basis [3]
After the end of the procedure, patients were transferred to a recovery area, drinks were served to them upon their request, oral medication could be resumed, the duration of sensory block was determined by noting the time when there was return of dull sensation to pinprick, and the duration of motor blockade was defined as the time interval between cessation of movement in the limb until Bromage (1)
Summary
In the era of ultrasound-guided regional techniques, we searched for short and potent local anesthetic for patients undergoing ambulatory upper limb procedures. Studies about articaine efficacy in brachial plexus block are limited. We compared its safety and efficacy against bupivacaine as a commonly used anesthetic agent for ultrasound-guided supraclavicular brachial plexus block. We measured motor and sensory block duration as a primary outcome. Other secondary outcomes such as onset of block, duration of analgesia, patient satisfaction, and time to home discharge readiness were measured. E onset of motor block was faster in group A (8.73 ± 4.33 min), and the postoperative VAS score was lower in group B. Earlier resolution of articaine block makes it more favorable than bupivacaine for ambulatory surgery. Earlier resolution of articaine block makes it more favorable than bupivacaine for ambulatory surgery. is trial is registered with (NCT04189198)
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