Bupivacaine In Brachial Plexus Block Research Articles

Effect of Dexmeditomidine in Supraclavicular Brachial Plexus Block

Introduction: Alpha-2 agonists are mixed with local anaesthetic agents to extend the duration of spinal, extradural and peripheral nerve blocks. We studied the effect of dexmeditomidine as an adjuvant to bupivacaine in brachial plexus block on onset and duration of sensory and motor block, duration of analgesia, level of sedation, perioperative hemodynamic parameters and complications. Methods: Forty patients of ASA ? and ASA ?? scheduled for upper limb surgery were included in double blind randomised comparison of inj. Dexmeditomidine and inj. Normal saline. We divided patients in two groups. Group A patients were given inj dexmeditomidine 50 microgm (0.5ml) and group B patients were given inj normal saline in brachial plexus block as adjuvant to 30 ml of local anaesthesic solution containing 14 ml of lidocaine with adrenaline and 16ml bupivacaine. We recorded time of onset and duration of sensory and motor block, level of sedation, duration of analgesia, hemodynamic changes and side effects in both groups. Results: mean time to onset of sensory block was 5.42±1.39 min in group A and 8.34± 1.35 min group B and that of motor block was 11.1± 2.6min in group A and 18.0± 2.9min in group B. Total duration of sensory block was 730.15±78.27min in group A and 360.62±61.7min in group B and that of motor block was 616.2± 54.46min in group A and 288.4± 54.26min in group B. Duration of analgesia was 970.36 ± 80.7 min in group A and 300±40.31 min in group B. Conclusion: addition of 50 microgm of inj dexmeditomidine to bupivacaine in brachial plexus block shortens onset and prolongs duration of sensory and motor block, prolongs duration of analgesia and decreases intraoperative requirement of sedatives. Key words: Supraclavicular Brachial Block, Dexmeditomidine, Analgesia, Sedatio

A Comparative Study of Addition of Midazolam to Lignocaine—Bupivacaine vs only Lignocaine— Bupivacaine in Brachial Plexus Block

ABSTRACTIntroductionThis prospective, randomized, double-blind study compared the onset and duration of sensory blockade, motor blockade, and analgesia with lignocaine, bupivacaine, and midazolam combination vs only lignocaine, bupivacaine in brachial plexus block.Materials and methodsPatients of either sex, aged 18–60 years, American Society of Anesthesiologists grade I/II, posted for upper limb surgeries to be performed under supraclavicular brachial plexus block with the help of peripheral nerve stimulator were administered either 10 ml 0.5% bupivacaine with 50 μg/kg midazolam (preservative free) + 20 ml 2% lignocaine with adrenaline (1:200,000) in Group lignocaine– bupivacaine–midazolam (LBM) or 10 ml 0.5% bupivacaine + 20 ml 2% lignocaine with adrenaline (1:200,000) in Group lignocaine–bupivacaine (LB).Onset and duration of sensory and motor blockade were monitored. Postoperative analgesia was graded with visual analog scale. Sedation was monitored with Ramsey sedation score.ResultsA total of 60 patients were randomized to the group LBM (n = 30) and group LB (n = 30). The analgesia was significantly prolonged in the study group, with a mean of 11.72 ± 1.924 hours as compared with a mean of 6.383 ± 1.031 hours in the control group. Sedation scores were higher in the study group, that is, group LBM compared to group LB postoperatively.ConclusionIn conclusion, midazolam when added to bupivacaine and adrenalized lignocaine for supraclavicular brachial plexus block hastens the onset of sensory and motor blockade. This combination improves analgesia, as manifested by lower pain scores and prolonged duration of analgesia.How to cite this articleDalvi NP, Salunkhay H, Mohite SN. A Comparative Study of Addition of Midazolam to Lignocaine–Bupivacainevsonly Lignocaine–Bupivacaine in Brachial Plexus Block. Res Inno in Anaesth 2016;1(1):5-9.

Nalbuphine as an adjuvant to 0.5% bupivacaine for ultrasound-guided supraclavicular brachial plexus blockade

Background: Brachial plexus block is a reliable, regional anesthetic technique for upper arm surgeries. Opioid agonist-antagonists are also used as adjuvant to enhance the analgesia of bupivacaine. The present study was aimed to assess the analgesic efficacy and safety of nalbuphine as an adjuvant to 0.5% bupivacaine for brachial plexus block. Patients and Methods: Sixty adult patients of American Society of Anesthesiologists physical status I and II of both genders were randomized into two groups of thirty patients each to receive either 20 mL of 0.5% bupivacaine with 1 mL of normal saline (Group 1) or 20 mL of 0.5% bupivacaine with 1 mL of nalbuphine 10 mg (Group 2) for brachial plexus block under ultrasound guidance. Patients were observed for onset and duration of sensory and motor block with duration of pain relief as primary end points while occurrence of any adverse effect due to technique or nalbuphine was noted as secondary outcome. Results: The ultrasound guided the visualization of the nerves, needle, and spread of local anesthetic at brachial plexus block site. Nalbuphine did not affect the onset time of block but enhanced the duration of sensory and motor block. The duration of postoperative analgesia was 481.53 ± 42.45 min in Group 2 and 341.31 ± 21.42 min in Group 1, with statistically highly significant difference (P < 0.001). There were no hemodynamic variations and no complication of technique or adverse effects due to nalbuphine occurred. Conclusion: Nalbuphine 10 mg has significantly extended the duration of analgesia of brachial plexus block with no adverse effects.

Comparative study of 0.5% ropivacaine and 0.5% bupivacaine for brachial plexus block by supraclavicular approach for upper limb surgeries

Background: Present study was undertaken to evaluate the clinical efficacy of 0.5% ropivacaine for supraclavicular bronchial plexus block for upper limb surgeries and comparing it with 0.5% bupivacaine in terms of characteristics of supraclavicular blockade and side effects. Methods: The design was a prospective double blind randomized study enrolling 60 patients of either sex, ASA I and II, were randomly allocated into two groups in which supraclavicular brachial plexus block was performed with nerve stimulator using 30 ml of ropivacaine 0.5% and bupivacaine 0.5% respectively. The onset and duration of sensory and motor block and possible adverse events were recorded.Results: Ropivacaine had earlier onset of sensory and motor blockade compared to bupivacaine. The duration of sensory and motor blockade was longer in group of patients treated with ropivacaine than in bupivacaine group. No statistically significant difference was found in quality of blocks in both groups. There were no adverse effects observed in the study.Conclusions: Ropivacaine 0.5% can be safely used as an alternative to bupivacaine 0.5% in supraclavicular bronchial plexus block.

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A comparative study of 0.375% bupivacaine with midazolam and 0.375% bupivacaine for brachial plexus block in upper limb surgeries

A comparative study of 0.375% bupivacaine with midazolam and 0.375% bupivacaine for brachial plexus block in upper limb surgeries

Comparison of the effects between clonidine and epinephrine added with bupivacine in brachial plexus block

Background: Demonstration of alpha adrenoreceptors in the peripheral nervous system has made to study the effects of various alpha adrenergic drugs with local anesthetics in peripheral nerve blocks. This study is designed to compare the efficacy of clonidine and epinephrine when added to bupivacaine in brachial plexus block. Methods: Forty ASA 1 and 2 patients undergoing upper limb surgeries under supraclavicular brachial plexus block were divided into two groups in a randomized double blinded fashion. Group BA received 5 mcg/ml of adrenaline and group BC recieved mcg/ kg of clonidine along with 30 ml of 0.375% bupivacaine. Onset of sensory and motor blockade, duration of analgesia, hemodynamic stability were studied in both the groups. Results: Onset of sensory and motor blockade were 6.25+1.33 minutes and 3.80+0.834 minutes respectively in group BA and 5.85+1.26 minutes and 3.55+1.05 minutes respectively in group BC which were not statistically significant between the two groups. Duration of analgesia was 7.12+0.63 hours in group BA and 12.69+1.28 hours in group BC which was statistically significant (p value 0.001). There were no significant difference in the hemodynamic parameters between the two groups. Conclusion: Addition of clonidine to bupivacaine in supraclavicular brachial plexus block provides a significant advantage over epinephrine to bupivacaine in terms of postoperative analgesia without any significant side effects.

Buprenorphine as an adjuvant in supraclavicular brachial plexus block.

Background and Aims: Brachial plexus block is a useful alternative to general anaesthesia. Postoperative analgesia is an added advantage. Buprenorphine, an agonist antagonist opioid has been used by various routes to prolong analgesia. The present study was undertaken to assess the analgesic efficacy of Buprenorphine with Bupivacaine in brachial plexus block. Methods: A prospective, randomized, double blind study was done on 60 adult patients of ASA 1 and 2, aged between 18-50 years and scheduled for various upper limb surgeries. Patients were divided into two groups of 30 each. Group C (control group) received 38ml of inj. bupivacaine 0.25% +2ml normal saline and group B (Buprenorphine group) received 38ml of inj. bupivacaine 0.25% +2ml inj. Buprenorphine (preservative free) (0.3 mg). Patients were observed for onset and duration of motor block, onset and duration of sensory block , duration of pain relief and occurrence of any complications. Results:

Evaluation of two regional anesthetic methods on the front limb of dogs using hyperbaric bupivacaine

To evaluate the effects of bupivacaine 0.5 and 0.25% in intravenous regional anesthesia (IVRA) and brachial plexus block (BPB), respectively, on anesthesia, motor block and cardiovascular parameters in dogs. Fourteen healthy adult dogs averaging 10 kilograms (kg) of body weight. Animals were randomly assigned to receive one of the two treatments IVRA (n=7) or BPB (n=7). All the animals were sedated with acepromazine (0.1 mg/kg intramuscular). To execute the BPB was used an electrical nerve stimulation. Anesthesia, motor block, sedation, cardiovascular and respiratory effects were measured as effect of the treatment. BPA showed superior efficiency and duration of anesthesia (BPB - 456 +/- 94 minutes vs IVRA - 138 +/- 44) as well as motor block. There only physiologic parameter which change were the systolic pressure in BPB and respiratory rate for both treatments. In dogs the 0.25 % hyperbaric bupivacaine in BPB produces a front limb anesthesia about three times more than the 0.5 % in IVRA, with ptosis of the limb blocked and little interference in the cardiovascular system but with decrease in respiratory rate.

The Effect of Clonidine Administered with Bupivacaine in Brachial Plexus Block

The Effect of Clonidine Administered with Bupivacaine in Brachial Plexus Block

A Comparison of Ropivacaine 0.5% and Bupivacaine 0.5% for Brachial Plexus Block

This study compared the effectiveness of 0.5% ropivacaine and 0.5% bupivacaine for brachial plexus block. Forty-eight patients received a subclavian perivascular brachial plexus block for upper-extremity surgery. One group (n = 24) received ropivacaine 0.5% (175 mg) and a second group (n = 24) received bupivacaine 0.5% (175 mg), both without epinephrine. Onset times for analgesia and anesthesia in each of the C5 through T1 brachial plexus dermatomes did not differ significantly between groups. Duration of analgesia and anesthesia was long (mean duration of analgesia, 13-14 h; mean duration of anesthesia, 9-11 h) and also did not differ significantly between groups. Motor block was profound, with shoulder paralysis as well as hand paresis developing in all of the patients in both groups. Two patients in each group required supplemental blocks before surgery. Ropivacaine 0.5% and bupivacaine 0.5% appeared equally effective in providing brachial plexus anesthesia.

The Effect of Morphine administered with Bupivacaine in Brachial Plexus Block

The Effect of Morphine administered with Bupivacaine in Brachial Plexus Block