Application of dexmedetomidine combined with ropivacaine in axillary brachial plexus block in children and its effect on inflammatory factors

Yang, Haikou; Fan, Wei; Yang, Yong; Zhou, Jing; Zhang, Hao; Sun, Jian; Wang, Bo

doi:10.14715/cmb/2020.66.5.14

Cited by 3 publications

(1 citation statement)

References 41 publications

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“…Sevoflurane, as an inhalation anesthetic, is widely used through laryngeal mask airway in anesthesia of children's surgery because of its small irritation to respiratory tract, quick induction of anesthesia, easy acceptance by children and high safety (Zhong et al, 2018). In addition, the brachial plexus is the main nerve innervating the upper limb and scapula, and when it is abnormal, the upper limb movement will be restricted (Yang et al, 2020). Local anesthetics are injected all over the brachial plexus trunk (cervival, supraclavicular and axillary approachs) during brachial plexus block, which blocks the innervated tissues (Fig.…”

Section: Introductionmentioning

confidence: 99%

Application Value of Sevoflurane Combined with Brachial Plexus Block in Children with Humeral Fracture Surgery and its Effect on Hemodynamics: A Clinical and Anatomical Study

Gui,

Xu,

Shu

et al. 2023

Int. J. Morphol.

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To observe the effect of sevoflurane combined with brachial plexus block (BPB) in children with humeral fracture surgery and its effect on hemodynamics. 84 children who received surgical treatment of humeral fracture in our hospital from September 2019 to September 2022 were selected. According to different anesthesia methods, the children were divided into control group and study group. The control group only received laryngeal mask sevoflurane; the study group received laryngeal mask sevoflurane combined with BPB. The operation situation, hemodynamic indexes, stress level, pain and adverse reactions of children was observed. The postoperative awakening time in the study group was lower than control group, the postoperative pain onset time in the study group was higher than control group (P<0.05). Intraoperative and postoperative 2 h, mean arterial pressure and heart rate in the study group were lower than control group (P<0.05). Preoperative, intraoperative, and postoperative 2h, there was no significant difference in oxygen saturation between the two groups (P>0.05). Postoperative 2h, the levels of serum cortisol, b-endorpin, norepinephrine and epinephrine in the study group were lower than control group (P<0.05). Postoperative 2 h, 12 h, 24 h, the visual analogue scale scores in the study group were lower than control group (P<0.05). There was no statistical difference in adverse reactions between the two groups (P>0.05). Sevoflurane combined with BPB is helpful to shorten the postoperative awakening time of children with humeral fracture, reduce the degree of postoperative pain, improve hemodynamics, and reduce stress response, and has good safety.

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Section: Introductionmentioning

confidence: 99%

Application Value of Sevoflurane Combined with Brachial Plexus Block in Children with Humeral Fracture Surgery and its Effect on Hemodynamics: A Clinical and Anatomical Study

Gui,

Xu,

Shu

et al. 2023

Int. J. Morphol.

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Ropivacaine combined with dexmedetomidine in ultrasound-guided axillary brachial plexus block in children, a randomized controlled trial

Chen,

Su,

Zhang

et al. 2024

Eur J Med Res

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Objective In this study, we evaluated the efficacy and safety of 1 μg/kg dexmedetomidine as an adjuvant treatment to ropivacaine in children undergoing upper limb surgeries under ultrasound-guided axillary brachial plexus blocks and general anesthesia. Methods We enrolled 90 children (aged 1–8 years; ASA I-II) undergoing closed reduction and internal fixation for upper extremity fractures at the Xiamen Children's Hospital and randomly assigned them to one of two groups: L (injection with 0.25% ropivacaine) or D (injection with 0.25% ropivacaine containing 1 μg/kg dexmedetomidine) using the random number table method. The main outcome indicators recorded were the facial expression, leg activity, position, crying, and Face, Legs, Activity, Cry, and Consolability (FLACC) scale scores of children after surgery and the duration of block and analgesia maintenance. The secondary outcome indicators were vital sign data at the time of ultrasound probe placement (T1), at the time of block completion (T2), prior to the beginning of surgery (T3), 5 min after the beginning of surgery (T4), and at the end of surgery (T5), as well as the time of postoperative recovery, the number of cases of remedial analgesia, and complications. Results There was no statistical difference between the two groups in terms of general data, block completion time, postoperative recovery time, and complications (P > 0.05). Compared to the L group, the D group had significantly lower FLACC scores at 6 h after surgery, as well as significantly lower systolic blood pressure, diastolic blood pressure, and heart rate values at T4 and T5, and significantly longer duration of postoperative analgesia maintenance (all P < 0.05). Conclusion Dexmedetomidine (1 μg/kg) as a local anesthetic adjuvant to ropivacaine can alleviate pain at 6 h postoperatively, prolong analgesia maintenance, and reduce intraoperative blood pressure and heart rate in pediatric patients undergoing closed reduction and internal fixation for upper extremity fractures, with no obvious complications or delayed recovery. Clinical registry number Registration website: www.chictr.org.cn, Registration number: ChiCTR2200065163, Registration date: October, 30, 2022. Supplementary Information The online version contains supplementary material available at 10.1186/s40001-024-01997-z.

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Comparison of effects of two analgesia methods on surgery for developmental dysplasia of the hip in children

Peng,

Zhang,

et al. 2024

VOJNOSANIT PREGL

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Background/Aim. Surgery for developmental dysplasia of the hip (DDH) often needs acetabuloplasty and femoral osteotomy. This type of operation is characterized by long duration, major trauma, and severe postoperative pain. The aim of the study was to compare the analgesic effects of the caudal block (CB) and epidural block (EB) on the DDH surgery in children. Methods. A total of 100 children undergoing DDH surgery in our hospital from May 2018 to December 2021 were selected and randomly divided into two groups: an ultrasound-guided CB group and an EB group (each group consisting of 50 children). The dosage of ropivacaine, changes in blood pressure, heart rate, and intraoperative dosage of fentanyl were recorded. In addition, we recorded the values of several parameters after the surgery: the modified Face, Legs, Activity, Cry, and Consolability (FLACC) scale score at 2, 4, 6, 12, 24, 36, and 48 hrs after surgery; the time point of first-time request for acetaminophen and proportion of patients using pethidine; the sedation degree within 12 hrs after the operation (assessed using the Ramsay Sedation Scale - RSS); the incidence of nausea, vomiting, and urinary retention; the satisfaction degree of family members with the applied methods of postoperative analgesia in children. Results. The ropivacaine dosage used in the CB group exceeded that of the EB group (p < 0.05). The CB group had lower FLACC scores 12 and 24 hrs after the operation and a longer postoperative time until the first-time request for acetaminophen than the EB group (p < 0.05). No block-related complications occurred; the two groups had similar incidence rates of nausea, vomiting, and urinary retention. The RSS score within 12 hrs after operation was higher in the CB group than in the EB group, and the family members of the children in the CB group were more satisfied (p < 0.05). Conclusion. Both CB and EB can provide satisfactory intraoperative and postoperative analgesia for pediatric hip surgery. However, CB provides effective analgesia for 24 hrs after the operation and lasts longer than that accomplished by the EB.

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Application of dexmedetomidine combined with ropivacaine in axillary brachial plexus block in children and its effect on inflammatory factors

Cited by 3 publications

References 41 publications

Application Value of Sevoflurane Combined with Brachial Plexus Block in Children with Humeral Fracture Surgery and its Effect on Hemodynamics: A Clinical and Anatomical Study

Application Value of Sevoflurane Combined with Brachial Plexus Block in Children with Humeral Fracture Surgery and its Effect on Hemodynamics: A Clinical and Anatomical Study

Ropivacaine combined with dexmedetomidine in ultrasound-guided axillary brachial plexus block in children, a randomized controlled trial

Comparison of effects of two analgesia methods on surgery for developmental dysplasia of the hip in children

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