Does fentanyl prolong the analgesia of local anaesthetics in brachial plexus block? A randomized controlled study

Kaniyil, Suvarna; Radhakrishnan, Priya

doi:10.18203/2320-6012.ijrms20170156

Cited by 4 publications

(5 citation statements)

References 18 publications

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“…On the other hand, there were studies that had used fentanyl as adjuvant to local anesthetics during regional or peripheral nerve blocks and resulted in significant prolongation of duration of analgesia. [ 13 ]…”

Section: Discussionmentioning

confidence: 99%

Dexmedetomidine and fentanyl as an adjunct to bupivacaine 0.5% in supraclavicular nerve block: A randomized controlled study

2018

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Background:Brachial plexus block is gaining popularity day by day for upper limb surgery. The supraclavicular brachial plexus block may be used for surgical anesthesia alone or in conjunction with general anesthesia.Aims:We intended to compare the effect of dexmedetomidine and fentanyl as adjuvant to bupivacaine on onset and duration of block and postoperative analgesia during ultrasonic guided supraclavicular nerve block for upper limb surgeries.Settings and Design:This study design was a prospective randomized controlled double-blinded clinical study.Patients and Methods:Sixty patients with American Society of Anesthesiologists physical status Classes I and II, aged 18–50 years, scheduled for upper limb surgery were randomly divided into three study groups each group contains 20 patients: C Group: receive 0.5 mL/kg up to a maximum of 40 mL volume. The dose of bupivacaine was 1.5 mg/kg. D Group: Bupivacaine as control group + 1 mg/kg dexmedetomidine. F Group: Bupivacaine as control group + 1 mg/kg fentanyl. Patients were observed for onset and duration of sensory and motor blockade, duration of analgesia, postoperative pain, and adverse effects.Statistical Analysis Used:One-way ANOVA test and Chi-square test were used.Results:The onset time of sensory and motor blockade was shortened. and the duration of the block was significantly prolonged in the D Group (P < 0.001) and F Group (P < 0.001). The duration of postoperative analgesia was also longer in the D Group 13.5 h compared with the F Group 8.3 h and C Group 7.5 h. Hypotension and bradycardia were recorded in 2 patients in D Group, and nausea and vomiting were recorded in F Group.Conclusions:Addition of dexmedetomidine was better in prolongation of the duration of supraclavicular brachial plexus block and improvement of postoperative analgesia than fentanyl and bupivacaine alone without significant adverse effects in patients undergoing upper limb surgeries.

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Section: Discussionmentioning

confidence: 99%

Dexmedetomidine and fentanyl as an adjunct to bupivacaine 0.5% in supraclavicular nerve block: A randomized controlled study

2018

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“…These findings corroborative to the results of other researchers' works. 1,2,9,11,27 Regarding post-operative rescue analgesic requirement, group BD performed better than group BF showing lesser need of administration of repeated doses. About 80% and 20% of fentanyl group patients required 2 nd and 3 rd of rescue analgesic, respectively, compared to 5.7% and 0% in dexmedetomidine group, respectively, P<0.001 (Table 2).…”

Section: Discussionmentioning

confidence: 95%

“…The perineural nerve blockade technique, although developed early in the history of anesthesia, remains a well-accepted, versatile anesthetic technique and unavoidable component of today's comprehensive anesthetic management. 1 Brachial plexus block (BPB) is a useful regional anesthetic technique and a superior alternative to general anesthesia for upper limb surgeries as they achieve near-ideal operating conditions by producing complete muscular relaxation, maintaining stable intra-operative hemodynamic and also providing benefits of reduced hospital stay, less financial burden and avoidance of complications due to general anaesthesia. 2 Once described as the "spinal of the arm" due to its relatively rapid onset and reliability, a supraclavicular BPB offers dense anesthesia of the brachial plexus for any surgery involving the upper extremity, but not the shoulder.…”

Section: Introductionmentioning

confidence: 99%

Comparison of perineural administration of dexmedetomidine and fentanyl as an adjuvant to 0.5% bupivacaine to enhance the quality of supraclavicular brachial plexus nerve block in upper limb surgeries - A prospective, triple-blind, randomized study

2022

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Background: Supraclavicular approach of brachial plexus block (BPB) has been in popular choice in recent years for surgical, diagnostic, and therapeutic management of injury and pathology related to upper limb. Aims and Objectives: In this study, we investigated the effect of dexmedetomidine and fentanyl as an adjuvant to bupivacaine on quality of block and post-operative analgesia in perineural supraclavicular BPB. Materials and Methods: A prospective, randomized, and triple-blind study was done involving 70 patients of age 18–60 years, randomly allocated into two equal groups [group BD- bupivacaine (0.5%) 29 ml with 100 μg (1 ml) of dexmedetomidine and group BF - bupivacaine (0.5%) 29 ml with 50 μg (1 ml) of fentanyl]. The scores of modified Gormley and Hill scale, modified Bromage scale, Ramsay sedation scale, and rescue analgesic requirement were recorded along with hemodynamic parameters. Pearson’s Chi-square test and Mann–Whitney U test were used for statistical analysis. Results: The onset time of sensory and motor blockade was shortened and the duration of the block was significantly prolonged in the BD Group than BF Group (P<0.001). The duration of post-operative analgesia was also longer in the BD Group compared with the BF Group (549.43±10.56 vs. 403.69±10.84) P<0.001. BF Group had more requirements of analgesic postoperatively. Conclusion: Addition of dexmedetomidine to bupivacaine prolonged the duration of perineural supraclavicular BPB and improvement of post-operative analgesia than fentanyl without significant side effects in patients undergoing upper limb surgeries.

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“…[12] Mechanism of fentanyl in prolongation of analgesia may be due to the existence of peripheral functional opioid receptors, but this existence in peripheral tissue is still doubtful. [13] A less likely mechanism of action is local anesthetic action of fentanyl. Local anesthetic properties of opioids have been discussed in earlier studies.…”

Section: Discussionmentioning

confidence: 99%

Peritubal infiltration of fentanyl compared to dexmedetomidine with ropivacaine in percutaneous nephrolithotomy: A randomized comparative analysis

et al. 2019

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Context: Dexmedetomidine has been found as an effective adjuvant in various nerve blocks. Despite several studies on dexmedetomidine with ropivacaine, there is no study on comparing with fentanyl in peritubal infiltration in percutaneous nephrolithotomy (PCNL). Aims: The aim of this study was to compare the effect of the addition of dexmedetomidine or fentanyl in peritubal local anesthetic infiltration on pain scores and analgesic consumption in patients who underwent PCNL. Settings and Design: This was a prospective, randomized, double-blind, tertiary care center-based study. Subjects and Methods: A total of 60 American Society of Anesthesiologists Class I, II, and III patients were selected and randomly divided into two groups: Group RF ropivacaine and fentanyl ( n = 30) and Group RD ropivacaine and dexmedetomidine ( n = 30). Balanced general anesthesia was given. After completion of the surgery, peritubal infiltration was given at 6 and 12 O’clock positions under fluoroscopic guidance. Postoperative pain was assessed using the visual analog scale and dynamic visual analog scale rating 0–10 for initial 48 h. Postoperative sedation was assessed using five-point sedation score. Time to first rescue analgesic, number of doses of tramadol, and total consumption of tramadol required in 48 h were noted. Statistical Analysis Used: Descriptive data were expressed in mean and standard deviation for between-group comparisons; the Chi-square and Fisher's exact tests were used for categorical variables, whereas t -test and Mann–Whitney U-test were used to compare continuous variables between two groups. Results: Duration of analgesia in group RD (12.87 ± 3.85) is more prolonged than group RF (8.13 ± 3.28) h. Total dose of rescue analgesia required in 48 h in group RF was higher as compared to group RD. Conclusions: Addition of dexmedetomidine to ropivacaine is more effective than fentanyl in terms of prolongation of analgesic efficacy of local anesthetic in peritubal block along with short-lived mild sedation.

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Does fentanyl prolong the analgesia of local anaesthetics in brachial plexus block? A randomized controlled study

Cited by 4 publications

References 18 publications

Dexmedetomidine and fentanyl as an adjunct to bupivacaine 0.5% in supraclavicular nerve block: A randomized controlled study

Dexmedetomidine and fentanyl as an adjunct to bupivacaine 0.5% in supraclavicular nerve block: A randomized controlled study

Comparison of perineural administration of dexmedetomidine and fentanyl as an adjuvant to 0.5% bupivacaine to enhance the quality of supraclavicular brachial plexus nerve block in upper limb surgeries - A prospective, triple-blind, randomized study

Peritubal infiltration of fentanyl compared to dexmedetomidine with ropivacaine in percutaneous nephrolithotomy: A randomized comparative analysis

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