Adding 5% Dextrose Water to Bupivacaine in Ultrasound-Guided Axillary Brachial Plexus Block

Faiz, Hamid Reza; Imani, Farnad; Entezary, Saeid Reza; Ziaifard, Mohesn; Koleini, Zahra Sadat; Rahimzadeh, Poupak

doi:10.5812/aacc.8313

Cited by 1 publication

(2 citation statements)

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“…Recently, the regional block has been used more often than general anesthesia. Performing this block in patients with difficult airway and underlying comorbid diseases is believed to be beneficial (3). Lower hospital stay, lower financial cost, and avoidance of general anesthesia complications, postoperative analgesia, and reduced opioid use and increased patient satisfaction are remarkable benefits that can be cited in comparison to a general anesthetic for peripheral nerve blocks (4,5).…”

Section: Introductionmentioning

confidence: 99%

“…On the other hand, the time gap between block administration and adequate analgesia is a complaint, especially for surgeons. The use of adjuvants and local anesthetic has been proposed for this shortcoming (3). Opioids are commonly known as analgesics that have their place of action in the central nervous system and the spinal cord, although their analgesic effect can also occur with the activation of peripheral chemoreceptors.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of the Ketamine-Lidocaine and Fentanyl-Lidocaine in Postoperative Analgesia in Axillary Block in Upper Limb Fractures By Ultrasound Guidance

et al. 2019

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Background: Regional anesthesia provides safe anesthesia for upper extremity surgery. Axillary plexus block approach for hand and forearm surgery is commonly used. The use of adjuvants in combination with local anesthetics for peripheral nerve blocks enhances the quality and duration of anesthesia and postoperative analgesia. Methods: This double-blind clinical trial was performed on 60 patients who were candidates for the surgery of upper extremity fractures with ASA I and II classes. The patients were randomly divided into two equal groups (n = 30). The intervention group 1 received 4 mg/kg lidocaine 1% and 50 µg fentanyl and the intervention group 2 received 4 mg/kg lidocaine 1% and 30 mg ketamine during the axillary block. After the necessary monitoring, a pinprick test was performed to evaluate sensory block, and a three-point scale test for the motor block was performed for median, ulnar, radial and musculocutaneous nerves. The duration of postoperative analgesia, the time of the first request for a painkiller, and the amount of opioid received were compared in the two groups. Results: Onset of sensory and motor block was shorter in the fentanyl group but did not differ significantly. The sensory and motor block length was slightly higher in the fentanyl group, but no significant difference was observed. The severity of pain (VAS) and the mean of received opioid (pethidine) were significantly lower in the fentanyl group 24 hours after the surgery (P < 0.0001). The duration of postoperative analgesia and the time of the first request for painkiller were longer in the fentanyl group, but there was no significant difference. Conclusions: The severity of pain and analgesic intake in the fentanyl group decreased significantly. Therefore, fentanyl is a better drug than ketamine for using as an adjuvant in the axillary block.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%