The Addition of Fentanyl to Local Anesthetics Affects the Quality and Duration of Cervical Plexus Block

Sindjelić, Radomir; Vlajković, G.; Davidović, Lazar; Marković, Dejan; Marković, Milan

doi:10.1213/ane.0b013e3181e1e9ab

Cited by 35 publications

(28 citation statements)

References 16 publications

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“…Prolongation of postoperative analgesia was reported in other studies also. 25 In our study we observed a significant prolongation of duration of analgesia with addition of fentanyl to local anaesthetics. Murphy DB et al 4,9 in their systematic review on analgesic adjuncts for brachial plexus block pointed out that evidences for analgesic benefit with addition of opioids in brachial plexus block over systemic opioids are minimal.…”

Section: Discussionsupporting

confidence: 47%

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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Section: Discussionsupporting

confidence: 47%

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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“…To the best of our knowledge, the present study is the first to investigate the effects of fentanyl addition to the TAP block on postoperative analgesia. A 2.5 µg/ml fentanyl dose (total dose, 100 µg) was selected in the present study, since previous studies have demonstrated that this concentration of fentanyl was able to significantly improve the effectiveness of peripheral nerve blocks (9)(10)(11)14). Furthermore, this dose was selected due to concerns regarding potential dose-dependent adverse systemic effects associated with fentanyl.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, various opioids, including fentanyl and sufentanil, have been shown to exert LA-like effects (8). However, the effects of opioids on peripheral nerve blocks are controversial; previous studies have reported both positive and negative effects for opioids (9)(10)(11)(12)(13)(14)(15)(16)(17). To the best of our knowledge, the use of opioids as analgesic adjuncts to the TAP block for postoperative analgesia are yet to be reported.…”

Section: Introductionmentioning

confidence: 99%

Addition of fentanyl to the ultrasound-guided transversus abdominis plane block does not improve analgesia following cesarean delivery

Wang¹,

Liu²,

Zhang³

et al. 2016

Experimental and Therapeutic Medicine

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Abstract. The present study aimed to investigate whether the addition of fentanyl to the transversus abdominis plane (TAP) block procedure may improve analgesic duration following cesarean delivery. A total of 147 nulliparous women with an American Society of Anesthesiologists physical status I-II, scheduled for elective cesarean delivery under spinal anesthesia, were enrolled in the present study. All patients underwent cesarean delivery under spinal anesthesia with 10 mg bupivacaine and 10 µg fentanyl, after which the patients underwent an ultrasound-guided bilateral TAP block with either 0.375% ropivacaine (group T R ; n=48), 0.375% ropivacaine and 50 µg subcutaneous fentanyl (group T R S F ; n=49), or a mixture of 0.375% ropivacaine and 50 µg fentanyl (2.5 µg/ml; group T RF ; n=50) per side. The TAP block formed part of a multimodal analgesic regimen comprising patient-controlled analgesia (PCA) with intravenous fentanyl, and regular treatment with diclofenac and paracetamol. The TAP block was performed in the midaxillary line using an in-plane technique. The primary outcome was the time to the first PCA, whereas secondary outcomes were the cumulative and interval PCA consumptions, visual analogue scale (VAS) pain scores at rest and during movement, side effects assessed at 2, 6, 12, 24 and 48 h postoperatively, and patient satisfaction with postoperative analgesia. No significant differences were observed in the median time to the first PCA among the three groups (P=0.640), which were 150 min (70-720 min) in group T R , 165 min (90-670 min) in group T R S F , and 190 min (70-680 min) in group T RF . Fentanyl consumption, VAS pain scores, side effects and patient satisfaction were similar among the three groups; however, the demand for fentanyl was significantly decreased in the T R S F and T RF groups at 2 h postoperatively (P=0.001 and 0.002, respectively), as compared with group T R . No complications attributed to the TAP block were detected. In conclusion, the results of the present study suggested that the addition of 2.5 µg/ml fentanyl to the TAP block procedure was unable to improve analgesia following cesarean delivery under spinal anesthesia.

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“…17 Prolongation of postoperative analgesia was reported in other studies also. 18 We also observed a significant prolongation of duration of analgesia with addition of fentanyl to local anaesthetics. Damien et al in their systematic review on analgesic adjuncts for brachial plexus block pointed out that evidences for analgesic benefit with addition of opioids in brachial plexus block over systemic opioids are minimal.…”

Section: Discussionmentioning

confidence: 59%

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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The Addition of Fentanyl to Local Anesthetics Affects the Quality and Duration of Cervical Plexus Block

Abstract: The addition of fentanyl to local anesthetics improved the quality and prolonged the duration of cervical plexus block in patients undergoing CEA.

Cited by 35 publications

References 16 publications

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

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

Addition of fentanyl to the ultrasound-guided transversus abdominis plane block does not improve analgesia following cesarean delivery

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

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