Effect of warmed ropivacaine solution on onset and duration of axillary block

Lee, Rippy; Kim, Young Mi; Choi, Eun Mi; Choi, Young-Sun; Chung, Moon Sang

doi:10.4097/kjae.2012.62.1.52

Cited by 13 publications

(4 citation statements)

References 17 publications

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“…Patients were classified according to the Hollman scale (Grade 1 = Full sensation; Grade 2 = Weak sensation; Grade 3 = Recognized as light touch; Grade 4 = Loss of sensation). 22 For the sensory assessment, the tip of the needle (22 Gauge short bevel) was applied to the skin with a force that was adequate to indent the skin but not enough to puncture it, in order to produce a consistent painful sensation when applied to the areas with normal sensation.…”

Section: Methodsmentioning

confidence: 99%

“…Time to motor block regression (duration of motor block), defined as the time between complete block (score 2) after local anesthetic injection (T0) and no motor block (score 0) on the modified Bromage scale was evaluated. 22 Motor block was assessed before and 10, 15, and 20 minutes after T0, and thereafter, every 30 minutes during surgery, and every hour in the postoperative period until its complete regression. Pharmacological therapy was based on patient response.…”

Section: Methodsmentioning

confidence: 99%

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Dexamethasone versus Dexmedetomidine as Adjuvants in Ultrasound Popliteal Sciatic Nerve Block for Hallux Valgus Surgery: A Mono-Centric Retrospective Comparative Study

Coviello,

Iacovazzo,

Cirillo

et al. 2024

DDDT

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Background and Aim Ultrasound popliteal sciatic nerve block (UPSNB) is commonly performed in foot and ankle surgery. This study aims to assess the use of dexmedetomidine and dexamethasone as adjuvants in UPSNB for hallux valgus (HV) surgery, comparing their efficacy in producing motor and sensory block and controlling postoperative pain. The adverse event rate was also evaluated. Methods This mono-centric retrospective study included 62 adult patients undergoing HV surgery: 30 patients received lidocaine 2% 200 mg, ropivacaine 0.5% 50 mg and dexamethasone 4 mg (Group 1), whereas 32 patients received lidocaine 2% 200 mg, ropivacaine 0.5% 50 mg, and dexmedetomidine 1 mcg/Kg (Group 2). At first, the visual analogue scale (VAS) was evaluated after 48 hours. The other outcomes were time to motor block regression, evaluation of the first analgesic drug intake, analgesic effect, adverse effects (hemodynamic disorders, postoperative nausea and vomiting (PONV)) and patient satisfaction. The continuous data were analyzed with student’s t- test and the continuous one with χ 2 . Statistical significance was set at a p-value lower than 0.05. Results No significant difference was found in VAS after 48 hours (4.5 ± 1.6 vs 4.7 ± 1.7, p = 0.621) to motor block regression (18.9 ± 6.0 vs 18.7 ± 6, p = 0.922). The number of patients that took their first analgesic drug in the first 48 h (p = 0.947 at 6 hours; p = 0.421 at 12 hours; p = 0.122 at 24 hours and p = 0.333 at 48 hours) were not significant. A low and similar incidence of intraoperative hemodynamic disorders was recorded in both groups (hypotension p = 0.593; bradycardia p = 0.881). Neither PONV nor other complication was found. Patients in Group 1 reported a lower degree of interference with sleep (p = 0.001), less interference with daily activities (P = 0.002) and with the affective sphere (P = 0.015) along with a more satisfactory postoperative pain management (p < 0.001) as compared to Group 2. Conclusion No significant differences were observed in the duration of motor and sensory blockade between patients in both groups. Additionally, both groups showed good pain control with a low rate of adverse effects, even if there was no clinical difference between the groups. However, patients who received dexamethasone reported experiencing less interference with their sleep, daily activities and overall emotional well-being, and overall pain control.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Dexamethasone versus Dexmedetomidine as Adjuvants in Ultrasound Popliteal Sciatic Nerve Block for Hallux Valgus Surgery: A Mono-Centric Retrospective Comparative Study

Coviello,

Iacovazzo,

Cirillo

et al. 2024

DDDT

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“…Interestingly, in addition to that, several studies have investigated if modifying the temperature of applied LAs can have an impact on the onset time of anesthesia. Of six studies published between 1987 and 2019 for various blocks and with different substances, four reported a shortened onset time after injection of pre-warmed LAs ( Mehta et al, 1987 ; Heath et al, 1990 ; Lim et al, 1992 ; Lee et al, 2012 ) and only one study reported no effect on onset time ( Chilvers, 2019 ).…”

Section: Clinical Perspectives and Future Directionsmentioning

confidence: 99%

Sodium Channels and Local Anesthetics—Old Friends With New Perspectives

Körner

Albani

Eswaran³

et al. 2022

Front. Pharmacol.

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The long history of local anesthetics (LAs) starts out in the late 19th century when the content of coca plant leaves was discovered to alleviate pain. Soon after, cocaine was established and headed off to an infamous career as a substance causing addiction. Today, LAs and related substances—in modified form—are indispensable in our clinical everyday life for pain relief during and after minor and major surgery, and dental practices. In this review, we elucidate on the interaction of modern LAs with their main target, the voltage-gated sodium channel (Navs), in the light of the recently published channel structures. Knowledge of the 3D interaction sites of the drug with the protein will allow to mechanistically substantiate the comprehensive data available on LA gating modification. In the 1970s it was suggested that LAs can enter the channel pore from the lipid phase, which was quite prospective at that time. Today we know from cryo-electron microscopy structures and mutagenesis experiments, that indeed Navs have side fenestrations facing the membrane, which are likely the entrance for LAs to induce tonic block. In this review, we will focus on the effects of LA binding on fast inactivation and use-dependent inhibition in the light of the proposed new allosteric mechanism of fast inactivation. We will elaborate on subtype and species specificity and provide insights into modelling approaches that will help identify the exact molecular binding orientation, access pathways and pharmacokinetics. With this comprehensive overview, we will provide new perspectives in the use of the drug, both clinically and as a tool for basic ion channel research.

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“…The onset of sensory and motor block was evaluated every 5 minutes for 20 minutes by Hollmen scale 6 for sensory effect and modified Bromage scale 7 for motor effect, until the block was finally established. The duration of sensory block was taken as time elapsed between injection of drug and return of pinprick sensation.…”

Section: Introductionmentioning

confidence: 99%

Twenty-four-hour Requirement of Rescue Analgesia after Upper Limb Surgery under Supraclavicular Brachial Plexus Block: A Role of Nalbuphine as an Adjuvant to Levobupivacaine

Kumari¹,

Gupta²,

Aggarwal³

2021

AMEI's Current Trends in Diagnosis &Amp; Treatment

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Background: Opioids have been used with peripheral nerve blocks for its synergistic effect to enhance the postoperative analgesic effectiveness of regional block. Nalbuphine, a newer opioid with an analgesic equivalence of morphine, has a ceiling effect on respiratory depression. The aim of the present study was to evaluate the effect of nalbuphine when used as an adjuvant to levobupivacaine on 24-hour postoperative analgesic requirement after brachial plexus block (BPB). Materials and methods: Sixty adult patients of either sex of American Society of Anesthesiologists (ASA) physical status I and II were randomized into two groups of 30 each to receive a total volume of 30 mL of study drug for supraclavicular brachial plexus block (SBPB): Group N-29 mL of 0.5% levobupivacaine with 1 mL of 10 mg nalbuphine; Group S-29 mL of 0.5% levobupivacaine with 1 mL of normal saline. Patients observed for 24-hour postoperative mean requirement of rescue analgesia, that is, diclofenac sodium, block characteristics, visual analog scale (VAS) scores, and the associated complications. Results: Demographic profile was comparable between the two groups. The mean dose of rescue analgesic required between the groups N and S was 127.5 ± 34.96 mg and 150 ± 37.5 mg (p = 0.000), respectively. The average VAS score at different time intervals was highly significant between the two groups (p <0.05). Similarly, block characteristics were statistically significant between the two groups; that is, onset was early, but the duration was prolonged in group N (p <0.05). Complications, although more in group N, were minor and statistically insignificant (p >0.05). Conclusion: Nalbuphine 10 mg as an adjunct to 0.5% levobupivacaine significantly reduced the requirement of rescue analgesia compared to placebo, with no significant major adverse effects.

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Effect of warmed ropivacaine solution on onset and duration of axillary block

Cited by 13 publications

References 17 publications

Dexamethasone versus Dexmedetomidine as Adjuvants in Ultrasound Popliteal Sciatic Nerve Block for Hallux Valgus Surgery: A Mono-Centric Retrospective Comparative Study

Dexamethasone versus Dexmedetomidine as Adjuvants in Ultrasound Popliteal Sciatic Nerve Block for Hallux Valgus Surgery: A Mono-Centric Retrospective Comparative Study

Sodium Channels and Local Anesthetics—Old Friends With New Perspectives

Twenty-four-hour Requirement of Rescue Analgesia after Upper Limb Surgery under Supraclavicular Brachial Plexus Block: A Role of Nalbuphine as an Adjuvant to Levobupivacaine

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