Fentanyl as an adjuvant for brachial plexus block: a randomized comparative study

Rajkhowa, Tejwant; Das, Nilotpal; Parua, Samit; Kundu, Rupak

doi:10.18203/2349-3259.ijct20160996

Cited by 10 publications

(19 citation statements)

References 18 publications

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“…mentioned in their study that fentanyl used with ropivacaine prolonged the duration of sensory and motor blockade, probably by directly binding with opioid binding sites on the dorsal nerve roots aided with these axonal transports or by diffusing into surrounding tissues and subsequently into the epidural and subarachnoid spaces; it may also have been central opioid receptor mediated after systemic absorption of fentanyl. [ 2 ] Regarding, MBP changes;results showed statistically significance in our study for dexmedetomidine This came in agreement with Rashmi and Komala. [ 14 ] Regarding onset of sensory and motor anesthesia, results showed statistically significance in our study for dexmedetomidine as adjuvant which has earlier onset of anesthesia than fentanyl group and control group while fentanyl has earlier onset than control group which came in agreement with Bharti et al .…”

Section: Discussionsupporting

confidence: 90%

“…mentioned in their study on fentanyl as adjuvant in brachial plexus nerve block that the 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. [ 2 ] Furthermore, Rajkhowa et al . mentioned in their study that fentanyl used with ropivacaine prolonged the duration of sensory and motor blockade, probably by directly binding with opioid binding sites on the dorsal nerve roots aided with these axonal transports or by diffusing into surrounding tissues and subsequently into the epidural and subarachnoid spaces; it may also have been central opioid receptor mediated after systemic absorption of fentanyl.…”

Section: Discussionmentioning

confidence: 99%

“…Dexmedetomidine (α 2 adrenoceptor agonist) is being used for intravenous (IV) sedation and analgesia for intubated and mechanically ventilated patients in Intensive Care Units. [ 2 ]…”

Section: Introductionmentioning

confidence: 99%

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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: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

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

2018

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“…Alkalinisation of local anaesthetic agents in nerve block has been shown to improve onset, quality and duration of analgesia. 16,17,18,19 The same observation is concluded in a study by Tejwant Rajkhowa, Nilotpal Das, Samit Parua, et al, 8 on effect of fentanyl as an adjuvant for brachial plexus block, single blinded study 66 ASA I and II patients aged 18-65 years were included and were divided into 2 groups, group R (35) and RF (31). Supraclavicular brachial plexus block was performed in the group R using 0.5% ropivacaine 30 ml plus 1 ml NS (total 31 ml) and in group RF received 0.5% Compared to group R, group RF showed a significant greater duration of sensory and motor blockade ropivacaine plus 50 micrograms fentanyl in 1 ml NS (total 31 ml) in brachial plexus block.…”

Section: Discussionsupporting

confidence: 55%

Comparative Study Between Bupivacaine Alone and Bupivacaine With Fentanyl in Axillary Plexus Block for Upper Limb Surgeries

P.V¹,

T²

2018

jebmh

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BACKGROUNDThe addition of adjuncts like Neostigmine, opioids, midazolam, dexmedetomidine, hyaluronidase, clonidine etc., to local anaesthetics for brachial plexus block may enhance the quality and duration of analgesia. Fentanyl, a phenylpiperidine derivative, is known to produce antinociception and enhance the effect of local anaesthetics when given epidurally or intrathecally. The purpose of the present study is to assess the effect of fentanyl added to brachial plexus block by axillary approach.

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“…15 Rajkhowa et al also demonstrated improved success rate and duration of analgesia with addition of 50µg of fentanyl to 0.5% ropivacaine in supraclavicular brachial plexus block. 16 In another study when 100µg of fentanyl added to axillary brachial plexus block, a doubling of postoperative analgesia was observed. 17 Prolongation of postoperative analgesia was reported in other studies also.…”

Section: Discussionmentioning

confidence: 95%

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

Kaniyil

Radhakrishnan

2017

Int J Res Med Sci

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Background: Several adjuvants have been added to enhance the effects of local anaesthetic agents in peripheral nerve blocks. In this randomized controlled study we aimed to assess the effects of addition of fentanyl to local anaesthetics in brachial plexus block with respect to onset time and total duration of analgesia.Methods: In this prospective randomized double- blind study, 40 adult patients of 18-65 years age group were randomly divided into two groups of 20 each. In group L supracavicular brachial plexus block was performed with 30 ml of local anaesthetic solution (10 ml 1.5% lignocaine with adrenaline +20 ml 0.25% bupivacaine) +1ml saline whereas in group LF received the same 30 ml local anaesthetics with 50µg fentanyl in 1ml added to it. The characteristics of block with respect to onset time of sensory and motor blockade, total duration of analgesia and any side effects were evaluated.Results: Both groups were comparable with respect to demographic parameters and duration of surgery. The onset time of complete sensory and motor block was significantly prolonged in group LF (17.2±2.5min and 20.3±2.9min) compared to group L (13.7±3.6min and 17.45±3.7min). The total duration of analgesia was also significantly prolonged (P <0.001) in group LF (374.5±51min) compared to group L (239.25±40.27min). There were no significant side effects noted in any patients in both groups.Conclusions: Addition of fentanyl to local anesthetics in brachial plexus block significantly prolonged the duration of analgesia without any significant side effects though it had delayed the onset of block.

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Fentanyl as an adjuvant for brachial plexus block: a randomized comparative study

Cited by 10 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

Comparative Study Between Bupivacaine Alone and Bupivacaine With Fentanyl in Axillary Plexus Block for Upper Limb Surgeries

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

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