Addition of fentanyl to bupivacaine prolongs anesthesia and analgesia in axillary brachial plexus block

Karakaya, Deniz; Büyükgöz, Fazl; Barış, Sibel; Güldoğuş, Fuat; Tür, Ayla

doi:10.1053/rapm.2001.24675

Cited by 42 publications

(26 citation statements)

References 16 publications

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“…The addition of small-dose fentanyl to lignocaine solution in brachial plexus block can increase the success rate and prolong the duration of analgesia,[16] but it delays the onset time of sensory blockade as compared with that achieved by the same doses of local anesthetics used in combination.…”

Section: Resultsmentioning

confidence: 99%

Effect of addition of fentanyl to local anesthetic in brachial plexus block on duration of analgesia

Chavan¹,

Koshire²,

Panbude³

2011

Anesth Essays Res

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Introduction/Context:A comparative study was carried out to evaluate the analgesic efficacy and side effects of addition of fentanyl to local anesthetic undergoing surgeries on forearm and elbow. All patients were hemodynamically stable, and there were no serious side effects in any of the patients in both the groups. The difference in the mean duration of analgesia between the groups was statistically significant (P<0.01). So we can conclude- Addition of Fentanyl to local anaesthetic in brachial plexus block increases duration of analgesia.Materials and Methods:Patients were randomly divided into two groups: group I (control) and group II (study). All the patients were subjected to brachial plexus block with supraclavicular approach. After obtaining paraesthesia, drugs were administered as follows: Group I (control): bupivacaine 0.5% 20 mL + lignocaine 2% 10 mL + NS 1 mL Group II (study): bupivacaine 0.5% 20 mL + lignocaine 2% 10 mL + fentanyl 1 mL (50 microgm). Observations were noted. All the relevant information was recorded on a pretested, predefined, semi-open pro forma sheet. Regular monitoring of PR, BP and RR, side effects,degree of sedation were recorded. Evaluation of pain and pain relief was done according to McGill pain questionnaire (0- no pain to 5- excruciating pain). When patients complained of discomforting pain (McGill grade II), parenteral analgesic was prescribed, and the total number of doses in the 24-hour period was noted.Results:The duration of analgesia in group II (study) was significantly longer (695±85 min) than those in group I (415±78 min). However, onset time of analgesia was prolonged in group 2. We conclude that the addition of fentanyl to local anesthetics causes an improved success rate of sensory blockade but a delayed onset of analgesia, although this may be accounted for by the decreased pH caused by fentanyl. There was no statistically significant difference in the incidence of side effects between the two groups.Conclusions:This study has shown that the mean duration of analgesia is extended if fentanyl is added to local anesthetics, without increasing the side effects.

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Section: Resultsmentioning

confidence: 99%

Effect of addition of fentanyl to local anesthetic in brachial plexus block on duration of analgesia

Chavan¹,

Koshire²,

Panbude³

2011

Anesth Essays Res

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“…The duration of analgesia with local anaesthesia alone can be prolonged with the use of indwelling catheters, but misplacement, migration and infection are the inherent problems with catheter placement (7,8). Adjuvants to local anaesthesia provide the benefits of prolonging the duration of action without the need of an additional procedure and risks of catheter insertion (9). Adjuvants, such as opioid and non-opioids, have been used for supraclavicular block to enhance the duration of analgesia and minimise the use of systemic analgesia (10,11).…”

Section: Discussionmentioning

confidence: 99%

Comparative Study of the Efficacy of Dexmedetomidine and Fentanyl as Adjuvants to Ropivacaine in Ultrasound-Guided Supraclavicular Brachial Plexus Block

Dharmarao

Holyachi

2018

Turk J Anaesth Reanim

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Objective: Supraclavicular brachial plexus block is preferable to general anaesthesia in upper limb surgeries. Various adjuvants have been added to improve the quality of the block and prolong postoperative analgesia. The aim of the present study was to compare the onset and duration of sensory and motor blockade with the quality of perioperative analgesia and postoperative complications provided by dexmedetomidine and fentanyl as adjuvants to ropivacaine under ultrasound (USG) guidance in supraclavicular block. Methods: A total of 80 patients with American Society of Anesthesiologists grade I/II scheduled for elective upper limb surgeries were randomly allocated into two groups. Group A received 30 mL of 0.5% ropivacaine with 1 µg kg -1 dexmedetomidine, and group B received 30 mL of 0.5% ropivacaine with 1 µg kg -1 fentanyl for supraclavicular brachial block using USG guidance. The onset and duration of sensory and motor block, time for requirement of rescue analgesia and adverse events during the perioperative period were noted. Results: The onset of sensory blockade was 13.95±1.34 min in the dexmedetomidine group and 14.18±1.41 min in the fentanyl group. There was a highly significant statistical difference in terms of the duration of the sensory blockade, i.e. 801.75±46.07 min with dexmedetomidine compared to 590.25±40.41 min with fentanyl (p<0.0001). The duration of motor blockade was highly statistically significant with 649.56±42.73 min in group A compared to 456.75±32.93 min in group B. Conclusion: Dexmedetomidine prolongs the duration of sensory and motor block and postoperative analgesia as compared to fentanyl when used as an adjuvant to ropivacaine in supraclavicular brachial plexus block and is not associated with any major adverse events. Keywords: Ropivacaine, dexmedetomidine, fentanyl, supraclavicular brachial plexus block Amaç: Supraklaviküler brakiyal pleksus bloğu, üst ekstremite ameliyatlarında genel anesteziye tercih edilebilir. Bloğun kalitesini artırmak ve postoperatif analjeziyi uzatmak için çeşitli yardımcı tedaviler eklenmektedir. Bu çalışmanın amacı supraklaviküler blokta utrason eşliğinde ropivakaine yardımcı olarak verilen deksmedetomidin ile fentanili, duyusal ve motor blok başlangıcı ve süresi, perioperatif analjezinin niteliği, ve postoperatif komplikasyonlar açısından karşılaştırmaktır. Yöntemler: ASA (American Society of Anesthesiologists) I/II sını-fında yer alan ve elektif üst ekstremite cerrahisi planlanan toplam 80 hasta rasgele iki gruba bölündü. Ultrason eşliğinde supraklaviküler brakiyal blok için, A grubuna 1 µg kg -1 deksmedetomidin ile birlikte 30 mL %0,5 ropivakain, B grubuna ise 1 µg kg -1 fentanil ile birlikte 30 mL %0.5 ropivakain verildi. Duyusal ve motor bloğun başlangıç ve süreleri, kurtarma analjezi gereksiniminin zamanı, ve perioperatif dönem boyunca yan etkiler kaydedildi. Bulgular: Duyusal bloğun başlaması deksmedetomidin grubunda 13,95±1,34 dakika, fentanil grubunda 14,18±1,41 dk olarak bulundu. Duyusal bloğun süresi açısından istatiksel olarak oldukça anla...

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“…showed significant increase in duration of action with the fentanyl group. [1617] The possible mechanism of action of fentanyl at peripheral level could be three. First, fentanyl could have direct action on the peripheral receptors.…”

Section: Discussionmentioning

confidence: 99%

Analgesic efficacy of transverse abdominal plane block after elective cesarean delivery – Bupivacaine with fentanyl versus bupivacaine alone: A randomized, double-blind controlled clinical trial

John¹,

Ranjan

Ramachandran

et al. 2017

Anesth Essays Res

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Background:The analgesic benefit of transversus abdominis plane (TAP) blocks for cesarean delivery remains controversial. In our study, we compared the analgesic efficacy of TAP block using local anesthetic bupivacaine and adjunct fentanyl with bupivacaine alone in patients undergoing elective cesarean section.Methods:Our study was a randomized, double-blind, controlled clinical trial where sixty patients undergoing elective cesarean delivery under subarachanoid block (2 ml of 0.5% bupivacaine) were randomized into two groups, A and B. At the end of the surgical procedure, bilateral TAP block was performed guided by the ultrasound. Group A received 38 ml of 0.25% bupivacaine and 2 ml of 50 μg of fentanyl, whereas Group B received 38 ml of 0.25% bupivacaine + 2 ml of normal saline. The total volume was divided equally and administered bilaterally. Each patient was assessed for 24 h after TAP block, for time to rescue analgesia, pain using visual analog scale (VAS) score at rest and on movement, hemodynamic parameters (heart rate and blood pressure), nausea, vomiting, and sedation. Diclofenac 75 mg was given as rescue analgesia when the patient complained of pain or when VAS score >4.Results:Prolonged postoperative analgesia was noticed with both the groups, with a mean time to rescue analgesia of approximately 6.5 h. There was no significant difference in time to rescue analgesia (6.49 ± 0.477 vs. 6.5 ± 0.480) when both the groups were compared among themselves. The pain scores among the two groups when compared did not show any added benefit. Incidence of nausea, vomiting, and sedation when compared between both the groups showed no difference.Conclusion:The TAP block as a part of a multimodal analgesic regimen definitely has a role in providing superior analgesia in the postoperative period. However, adjunct fentanyl to local anesthetic bupivacaine was found to have no added advantage when quality and duration of analgesia was compared.

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Addition of fentanyl to bupivacaine prolongs anesthesia and analgesia in axillary brachial plexus block

Abstract: The addition of 100 microg/mL fentanyl to 0.25% bupivacaine almost doubles the duration of analgesia following axillary brachial plexus block when compared with 0.25% bupivacaine alone.

Cited by 42 publications

References 16 publications

Effect of addition of fentanyl to local anesthetic in brachial plexus block on duration of analgesia

Effect of addition of fentanyl to local anesthetic in brachial plexus block on duration of analgesia

Comparative Study of the Efficacy of Dexmedetomidine and Fentanyl as Adjuvants to Ropivacaine in Ultrasound-Guided Supraclavicular Brachial Plexus Block

Analgesic efficacy of transverse abdominal plane block after elective cesarean delivery – Bupivacaine with fentanyl versus bupivacaine alone: A randomized, double-blind controlled clinical trial

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