Online ISSN: 2515-8260

Keywords : brachial plexus block


Study of additive effects of butorphanol with 0.375% levobupivacaine in supraclavicular brachial plexus block for upper limb surgeries

Anusha Balasubramanian, S A Mohamed Arif, Jagan Govindasamy

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 1, Pages 3329-3334

Brachial Plexus block either alone or as a part of an anaesthetic sequence is useful as it provides complete relaxation of muscles of upper extremities. Present study was aimed to study additive effects of butorphanol with 0.375% levobupivacaine in supraclavicular brachial plexus block for upper limb surgeries at a tertiary hospital.
Material and Methods: Present study was single-center, prospective, comparative study in patients aged 18–58 years, of both gender, with body mass index (BMI) <25 kg/m2, of American Society of Anesthesiologists (ASA) physical status I to II, scheduled for elective forearm and hand surgeries, Patients fit for surgery, were randomly allocated into two groups using as Group BB (1 mg of butorphanol) & group B (bupivacaine only).
Results: In present study, general characteristics such as age (year), gender (male/female), ASA (I/II), weight (kg), height (cm) & mean duration of surgery (min) were comparable among both groups & difference was not statistically significant. Time taken for procedure (min) & onset of sensory blockade (min) were comparable in both groups and difference was not statistically significant. Butorphanol when added to levobupivacaine in supraclavicular brachial plexus block had early onset of motor block, improves the quality of block, prolonged the duration of sensory and motor blockade as compared to levobupivacaine alone, and difference was statistically significant.  Prolonged the duration of analgesia and late requirement of rescue analgesia as compared to levobupivacaine alone, and difference was statistically significant.
Conclusion: Butorphanol added with 0.375% levobupivacaine in supraclavicular brachial plexus block for upper limb surgeries provides rapid onset of block, better analgesia, good hemodynamic stability and profound and longer analgesia

Comparative study between 20ml of 0.5% ropivacaine and 20ml of 0.5% levobupivacaine in ultrasound guided supraclavicular brachial plexus block for upper limb surgeries

Dr. Karthik M, Dr. Gowthaman R, Dr. Santhosh Tamilarasan, Dr. Subbulakshmi Sundaram

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 3521-3531

his study is aimed to compare the effects between 20ml of 0.5% Ropivacaine and 20ml of 0.5% Levobupivacaine in ultrasound guided supraclavicular brachial plexus block for Upper limb surgeries. Methodology: It was a prospective double blinded randomized controlled study in sixty adult patients undergoing upper limb surgeries admitted in Rajah Muthiah Medical college and hospital from November 2020 to November 2022. Result: Significant earlier onset of sensory blockade (p=0.001) and motor blockade (p=0.001), prolonged duration of sensory and motor blockade (p=0.001) was observed in group of patients receiving 0.5% levobupivacaine compared to 0.5% ropivacaine. Intraoperatively throughout the study heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were comparable in both the groups and found no statistically significant difference (p>0.05). The heart rate, systolic and diastolic blood pressure for both the groups were also compared postoperatively and observed no significant statistical difference (p>0.05). No adverse effects were observed in both the groups. Conclusion: 0.5% levobupivacaine used in ultrasound guided supraclavicular brachial plexus block for upper limb surgeries provides rapid onset of sensory and motor blockade and prolonged duration of analgesia compared to 0.5% ropivacaine.

A comparative study of dexmedetomidine and dexamethasone as adjuvants to ropivacaine in supraclavicular brachial plexus block

B Vani Prapurna, V Sudharani, S Kiran Kumar

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 5, Pages 54-60

Background: Enhancing the duration of sensory and motor blockade of regional anaesthesia is often desirable for prolonged surgeries and also provides pain relief in the immediate postoperative period. We performed a prospective, randomised, study to evaluate the effect of Dexmedetomidine and Dexamethasone as adjuvants to Ropivacaine in supraclavicular approach of brachial plexus block.
Study design: The study was a controlled, randomised, double-blinded, prospective study.
Methods: Sixty ASA physical status 1 and 2 patients undergoing elective hand, forearm and elbow surgeries under brachial plexus block were randomly divided to receive either 8 mg Dexamethasone + 30ml 0.5% Ropivacaine or 1 mcg/kg Dexmedetomidine + 30 ml 0.5% Ropivacaine. The block was performed using a nerve stimulator. Onset and duration of sensory and motor blockade and total duration of analgesia were measured. Vitals were recorded at 3, 5,10,15,30 and 45 minutes. Two sample ‘t’ test of difference between two means was used to analyse the differences between various parameters that were used in the cases. Categorical data was assessed by Chi square test and Fishers exact test. P value of < 0.05 was considered significant.
Results: The onset of sensory block and onset of motor block both were found to be sooner with Dexmedetomidine than Dexamethasone. The duration of sensory block and motor blockade and duration of analgesia was longer with Dexmedetomidine than Dexamethasone.
Conclusion: Both Dexmedetomidine and Dexamethasone enhanced the onset and duration of blockade but, the effect was found to be more pronounced with Dexmedetomidine.
 

Study to assess the effectiveness of Ropivacaine versus Ropivacaine plus Fentanyl combination in Brachial Plexus block by supraclavicular approach

Dr. Padmalatha Seelam, Dr. Manoj Patruni, Dr. Vengamamba Thummala, Dr. Vadlamudi Rajesh Kumar, Dr. Nalli Venkata Krishna Mallik

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 1597-1607

Introduction: One of the primary aims of anesthesia is to relieve the patient's pain and
agony, thereby the surgical procedures can be conducted without any discomfort. Relief of
intraoperative and postoperative pain has gained importance in recent years, considering the
central, peripheral and immunological stress response to tissue injury. Any expertise acquired
in this field should be extended into the postoperative period, which is the period of severe,
intolerable pain requiring attention. So there is need of extended analgesia without any side
effects in the process of achieving this goal. “Regional anaesthesia” is the term first used by
Harvey Cushing in 1901 to describe pain relief by nerve block 1. Regional nerve blocks are
based on the concept that pain stimulus conveyed by nerve fibers, which are amenable to
interruption anywhere along their pathway 2. Brachial plexus block is a valuable and safe
alternative to general anesthesia in upper limb surgeries. Interrupting the acute pain which
can help in limiting the development of chronic pain syndromes 3, 4. The effects of opioids on
regional blockade is controversial. So the present study is being undertaken to evaluate
Fentanyl as an adjuvant to Ropivacaine in supraclavicular brachial plexus block.
Methodology: Hospital based Prospective randomized single blinded study. Conducted on
eighty patients of ASA I and II posted for upper limb surgeries under supraclavicular block.
Patients were divided randomly by means of random number table generated by computer
into two groups as A and B. Each group consisting of 40 patients. Prior to the study
Institutional Ethical committee approval and consent from the patients were taken. The study
was conducted in the Department of Anesthesiology, at Katuri medical college &Hospital,
Guntur from January 2016 to October 2017.