Abstract
Background: Opioids added to local anesthetics for peripheral nerve blocks may intensify analgesia and prolong analgesic and sensorial block duration. These agents may also cause potentiation and prolongation of motor block. Objective: This study compared the postoperative effects of 30 mL of 0.25% bupivacaine +50 mcg fentanyl and 30 mL of 0.25% bupivacaine + 100 mcg fentanyl solutions for the ultrasound-guided infraclavicular block in patients undergoing elbow and forearm surgery. Methods: In this randomized double-blind study, thirty-six patients with risk of ASA class I-III were randomly allocated into 2 randomized groups. Ultrasound-guided infraclavicular blocks with 30 mL of 0.25% bupivacaine + 50 mcg fentanyl for group 1 and 30 mL of 0.25% bupivacaine + 100 mcg fentanyl for group 2 were performed before patients emerged from general anesthesia. After surgery, pain levels at rest and during movement were evaluated using the 10-cm visual analog scale (VAS) at recovery room admission, at the 15th and 30th minutes in the recovery room, and at the 2nd, 6th, 12th and 24th hours postoperatively. Both morphine and rescue analgesic requirements were recorded. Sensorial and motor block durations, patient satisfaction, and complications related to the infraclavicular block were recorded. Results: In both groups, no significant difference in VAS pain scores, total morphine and total rescue analgesic requirements, duration of sensorial and motor block, or patient satisfaction were observed. None of the patients experienced any complications. Conclusion: The mixtures of 0.25% bupivacaine + 50 mcg fentanyl and 0.25% bupivacaine + 100 mcg fentanyl showed similar postoperative effects.
Highlights
Opioids added to local anesthetics for peripheral nerve blocks may intensify analgesia and prolong analgesic and sensorial block duration
In previous brachial plexus block studies, it was shown that the addition of fentanyl to the local anesthetic agent prolonged the analgesic duration and increased the analgesic efficacy.[3,4]
Hadzic et al[9] compared general anesthesia and infraclavicular blockage in ambulatory hand surgeries and found that the analgesia score was better with infraclavicular blockade; no additional analgesia was needed, ambulation was earlier, and side effects were fewer
Summary
Opioids added to local anesthetics for peripheral nerve blocks may intensify analgesia and prolong analgesic and sensorial block duration These agents may cause potentiation and prolongation of motor block. Pain levels at rest and during movement were evaluated using the 10-cm visual analog scale (VAS) at recovery room admission, at the 15th and 30th minutes in the recovery room, and at the 2nd, 6th, 12th and 24th hours postoperatively Both morphine and rescue analgesic requirements were recorded. Ultrasound-guided peripheral nerve blocks both increase the efficiency of the intervention and reduce the amount of local anesthetic solution used as well the rate of access-related complications.[1,2] The infraclavicular block is a proven technique for postoperative pain control in patients undergoing forearm surgery, including on the distal humerus. In previous brachial plexus block studies, it was shown that the addition of fentanyl to the local anesthetic agent prolonged the analgesic duration and increased the analgesic efficacy.[3,4] On the other hand, the added fentanyl can potentiate the motor block and extend the block duration.[5,6]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
