A comparison of 0. They were divided into three groups of 30 each. Brachial plexus block is used in surgical procedures of the upper limbs. Supraclavicular block is preferred procedure for hand and fore-arm surgeries, as it is safe, has rapid onset and gives reliable anaesthesia. Worldwide, long acting bupivacaine has been the most popular local anaesthetic for supraclavicular block in patients undergoing elective upper limb surgeries.
Br J Anaesth ; However, bupivacaine is associated with various CNS and cardiac side effects and unintended intravascular injection of bupivacaine lead to cardiac arrest, prolonged resuscitation and a disproportionally high number of deaths [ 3 , 4 ]. Dexmedetomidine prolongs the effect of bupivacaine in supraclavicular brachial plexus block. Aim This study was conducted to investigate and compare the effectiveness of supraclavicular brachial plexus anaesthesia with two different concentrations of ropivacaine 0. Multiple comparison test with Bonferroni correction showed there was statistically significant difference in mean duration of sensory and motor block between Group A 0. Onset and duration of sensorimotor blockade, haemodynamic variables, sedation score, and adverse effects were secondary outcomes.
Brachial plexus block is used in surgical procedures of the upper limbs. The University of Auckland. Demographic data Click here to view.
Duration of analgesia was the primary outcome. The onset of sensory and motor block was similar in all the three groups.
Supraclavicular Regional Anaesthesia Revisited
Abdallah FW, Brull R. Group A received 30ml of 0. A gauge, mm, insulated, blunt needle and a nerve stimulator was used to identify the brachial plexus.
Failure to lose shoulder abduction after 30 min was considered as block failure. Brachial plexus block has long been considered a safe method when proper technique is followed, which includes monitoring and patient selection. J Anaesthesiol Clin Pharmacol ; Bblock analysis was done by using SPSS Find articles by Prabhat Kumar.
Ninety patients of age 18 to 60 years belonging to American Society of Anaesthesiologists ASA status 1 or 2, admitted to Pondicherry Institute of Medical Sciences were chosen for the study and were divided into three groups. However, we found that increasing the concentration of Ropivacaine from 0.
Supraclavicular Regional Anaesthesia Revisited
In search of better alternative, ropivacaine has been proposed as suprqclavicular promising drug with fewer cardiovascular and central nervous system toxic effects compared with bupivacaine [ 5 ]. They documented a mean onset of motor blockade of 48 min supraclaviculxr at the hand at the C5 and C6 dermatomes which was substantially longer compared to our findings.
Supraclavicular block of the brachial plexus was long regarded as the quintessential skill of the regional anaesthetist: Immediately after the block placement, patients were evaluated every 4min, by an operator unaware of the injected solution, by asking the patient to elevate the arm while keeping the elbow straight and at the hand by grip strength to determine loss of shoulder abduction deltoid sign as evidence of eupraclavicular successful motor blockade.
Find articles by Ramachandran R. The duration of sensory block with 0. Sample size was calculated using difference between the overall duration of sensory block of 50 minutes.
On the basis of our study, conclusions were drawn that onset of action of sensory, motor block was similar in all the groups. The envelope was opened by an anaesthesiologist not involved in the study and the study medication was prepared and handed over to the researcher.
Mean demographic data in group A, group B and group C. The study technique evolved to incorporate the modern technology, becoming ultrasound-guided axillary tunnel block.
Support Center Support Center. High concentrations of dexmedetomidine inhibit compound action potentials in frog sciatic nerves without alpha 2 adrenoceptor activation. Informed written consent was obtained after explaining the procedure to the patients in the language they understood.
However, bupivacaine is associated with various CNS and cardiac side effects and unintended intravascular injection of bupivacaine lead to cardiac arrest, prolonged resuscitation and a disproportionally high number of deaths [ 34 ]. Dexmedetomidine as an adjuvant to ropivacaine prolongs peripheral nerve block: The duration of motor block with 0.
Results The study population consisted of 90 patients posted for elective forehand surgery. Although safe, ropivacaine is found to be less potent than bupivacaine and has a slightly shorter duration of action along with some motor sparing qualities [ 8 ]. More recently, there has been a resurgence of interest in supraclavicular block: The onset of complete sensory and motor block observed with both ropivacaine groups and bupivacaine was similar A systematic review and meta-analysis.