Summary Sixtj, adult jeniules of'
SummaryEighty patients who presented for surgery of the forearm or hand were allocated randomly to one of two groups. In Group A , surgery was performed under supraclavicular brachial plexus block only; a mixture of equal parts of prilocaine 1 % and bupivacaine 0.5% without adrenaline was used. In Group B, supraclavicular brachial plexus block was performed using prilocaine I% alone, but in addition discrete nerve blocks were performed at elbow level using 0.5% bupivacaine without adrenaline. Patients in Group B had a signijicantly shorter duration of unwanted postoperative motor blockade and a sign@cantly longer duration of postoperative analgesia ( p < 0.005). Key wordsPain; postoperative. Anaesthetic techniques, regional; brachial plexus block, median nerve block, radial nerve block, ulnar nerve block.Most surgery of the forearm and hand can be performed under regional anaesthesia, particularly brachial plexus block. Ideally, any technique should provide rapid onset of surgical anaesthesia, analgesia of the upper arm to prevent tourniquet pain (if a tourniquet is used), adequate muscular relaxation, a relatively ischaemic field and, if possible, good postoperative analgesia. Prolonged postoperative analgesia may be produced by brachial plexus block with bupivacaine, but the latency may be unacceptably long and unwanted motor block may persist well into the postoperative period. Lignocaine and prilocaine produce a rapid onset of action, but provide analgesia for a relatively short time in the postoperative period.Many clinicians compromise by using a mixture of local anaesthetic agents for brachial plexus block to produce rapid onset and prolonged duration. There is an alternative approach. Supraclavicular brachial plexus block can be performed with either prilocaine or lignocaine to provide analgesia of the upper arm in order to obtund tourniquet pain, complemented by discrete nerve blocks at the elbow with bupivacaine. Unwanted postoperative motor block of the shoulder and elbow is reduced to a minimum, both in degree and duration, whilst both intra-and postoperative analgesia is improved both in latency and duration.This study was undertaken to compare these techniques. Patients and methodsThe study was approved by the district ethics committee. Eighty adult patients of ASA grades 1 to 3 who presented for surgery of the forearm or hand were studied. All patients were premedicated with temazepam 20 mg orally 1-2 hours pre-operatively. Each patient was then allocated to one of two groups according to a random number sequence. Patients in Group A received a supraclavicular brachial plexus block alone using Ball's technique' with a peripheral nerve stimulator.2 The local anaesthetic solution comprised equal volumes of prilocaine 1% and bupivacaine 0.5%, without adrenaline, in a volume of 0.5 ml/kg body weight to a maximum of 40 ml. In Group B, supraclavicular brachial plexus block was performed by the same method but using prilocaine 1% without adrenaline as the sole agent; the volume used was 0.5 ml/kg to a ma...
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.