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

Hamed, Mohamed Ahmed; Ghaber, Saffa; Reda, Ahmed

doi:10.4103/aer.aer_50_18

Cited by 25 publications

(29 citation statements)

References 16 publications

(23 reference statements)

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“…The present study also confirms the better analgesic-sparing effect of dexmedetomidine than fentanyl as demonstrated in the previous studies when used as an adjuvant to bupivacaine in supraclavicular nerve block[19] and wound infiltration in abdominal hysterectomy. [20]…”

Section: Discussionsupporting

confidence: 91%

Peritubal infiltration of fentanyl compared to dexmedetomidine with ropivacaine in percutaneous nephrolithotomy: A randomized comparative analysis

et al. 2019

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Context: Dexmedetomidine has been found as an effective adjuvant in various nerve blocks. Despite several studies on dexmedetomidine with ropivacaine, there is no study on comparing with fentanyl in peritubal infiltration in percutaneous nephrolithotomy (PCNL). Aims: The aim of this study was to compare the effect of the addition of dexmedetomidine or fentanyl in peritubal local anesthetic infiltration on pain scores and analgesic consumption in patients who underwent PCNL. Settings and Design: This was a prospective, randomized, double-blind, tertiary care center-based study. Subjects and Methods: A total of 60 American Society of Anesthesiologists Class I, II, and III patients were selected and randomly divided into two groups: Group RF ropivacaine and fentanyl ( n = 30) and Group RD ropivacaine and dexmedetomidine ( n = 30). Balanced general anesthesia was given. After completion of the surgery, peritubal infiltration was given at 6 and 12 O’clock positions under fluoroscopic guidance. Postoperative pain was assessed using the visual analog scale and dynamic visual analog scale rating 0–10 for initial 48 h. Postoperative sedation was assessed using five-point sedation score. Time to first rescue analgesic, number of doses of tramadol, and total consumption of tramadol required in 48 h were noted. Statistical Analysis Used: Descriptive data were expressed in mean and standard deviation for between-group comparisons; the Chi-square and Fisher's exact tests were used for categorical variables, whereas t -test and Mann–Whitney U-test were used to compare continuous variables between two groups. Results: Duration of analgesia in group RD (12.87 ± 3.85) is more prolonged than group RF (8.13 ± 3.28) h. Total dose of rescue analgesia required in 48 h in group RF was higher as compared to group RD. Conclusions: Addition of dexmedetomidine to ropivacaine is more effective than fentanyl in terms of prolongation of analgesic efficacy of local anesthetic in peritubal block along with short-lived mild sedation.

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Section: Discussionsupporting

confidence: 91%

Peritubal infiltration of fentanyl compared to dexmedetomidine with ropivacaine in percutaneous nephrolithotomy: A randomized comparative analysis

et al. 2019

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“…Clonidine has been used as an α2 agonist with ropivacaine in the axillary block [23]. In recent studies, the administration of dexmedetomidine has been described as an effective drug in increasing the block's time [24,25]. It also increased the risk of bradycardia, hypotension, and drowsiness [3].…”

Section: Discussionmentioning

confidence: 99%

The Effect of Dexmedetomidine in Combination with Bupivacaine on Sensory and Motor Block Time and Pain Score in Supraclavicular Block

Sane

Shokouhi

Golabi

et al. 2021

Pain Research and Management

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Background. Brachial plexus block is frequently recommended for upper limb surgeries. Many drugs have been used as adjuvants to prolong the duration of the block. This study aimed to assess the effect of dexmedetomidine with bupivacaine combination and only bupivacaine on sensory and motor block duration time, pain score, and hemodynamic variations in the supraclavicular block in upper extremity orthopedic surgery. Methods. This prospective, double-blind clinical trial study was conducted on 60 patients, 20 to 60 years old. Patients were candidates for upper extremity orthopedic surgeries. The sensory and motor block were evaluated by using the pinprick method and the modified Bromage scale. The postoperative pain was assessed by utilizing a visual analog scale. Results. The mean onset time of sensory and motor block in patients receiving only bupivacaine was, respectively, 31.03 ± 9.65 min and 24.66 ± 9.2 min, and in the dexmedetomidine receiving group, it was about 21.36 ± 8.34 min and 15.93 ± 6.36 minutes. The changes in heart rate and mean arterial blood pressure were similar in both groups. The duration of sensory and motor block and the time of the first analgesia request in the intervention group were longer. Postoperative pain was lower in the intervention group for 24 hours ( P = 0.001). Conclusion. Dexmedetomidine plus bupivacaine reduced the onset time of sense and motor blocks and increased numbness and immobility duration. Also, dexmedetomidine reduced postoperative pain significantly with the use of bupivacaine for supraclavicular blocks. Trial Registration. IRCT, IRCT20160430027677N15. Registered 05/28/2019, https://www.irct.ir/trial/39463.

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“…For the prolongation of the duration of the brachial plexus block, some authors recommend the addition of dexmedetomidine, which is better in prolonging the duration of the supraclavicular block, and the improvement of postoperative analgesia from fentanyl and bupivacaine without significant adverse effects in patients undergoing surgery of the upper extremities ( 9 ).…”

Section: Discussionmentioning

confidence: 99%

Comparison of Plexus Brachial Blockade Effect by Supraclavicular and Axillary Approach - our Experience

Suljevic

Suljević

Turan

et al. 2019

ACC

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Introduction. Brachialis plexus block is a frequently used method of regional anesthesia that can be performed in several ways and locations. It has been successfully performed to provide good anesthesia and analgesia lasting several hours for operative procedures on hands. It can be performed by paresthesia technique or by ultrasound that has almost pushed out the old conventional technique since it allows the visualization of the blockade performance. Target. In the paper we use our sample to try to determine which of the two locations of the blockageis more favorable for the patient, and which one gives a higher percentage of success or a better sensory blockade. Method. This is a retrospective study and includes 40 patients of both sexes that were operated on at the Clinic for Traumatology and the Clinic for Plastic Surgery of the University Clinical Center in Sarajevo in the period from 30 August 1993 to 30 August 1994. Patients were divided into two groups. Group I were patients who had an axillary approach to plexus brachialis (n-21) ASA I-II. Group II were patients who had supraclavicular access to plexus brachialis (n-19) ASA I-II. All patients received 0.5 ml / kg Bupivacaine 0.5%. In the study, we analyzed sex, age, duration of blockade and complications. Analgesia and motor block were evaluated 20 minutes after the local anesthetic injection. The complete block is defined as analgesia in all dermatomes (C5-Th1) 20 minutes after injection. The results. Group I had 20 male and 1 female patients while group II had 17 male and 2 female patients. The supraclavicular block enabled complete blockade in 18 patients (95.23%), and the axillary approach had a successful blockade in 17 patients (80.95%). In both groups the corresponding motor block was similar. The start of the engine block was similar in both groups. There were no significant complications in either group. Conclusion. Regarding clinical efficacy, both brachial plexus blocking approaches provided a good motor block, anesthesia and analgesia for the forearm or hand surgery. Supraclavicular approach proved to be more favorable.

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

Cited by 25 publications

References 16 publications

Peritubal infiltration of fentanyl compared to dexmedetomidine with ropivacaine in percutaneous nephrolithotomy: A randomized comparative analysis

Peritubal infiltration of fentanyl compared to dexmedetomidine with ropivacaine in percutaneous nephrolithotomy: A randomized comparative analysis

The Effect of Dexmedetomidine in Combination with Bupivacaine on Sensory and Motor Block Time and Pain Score in Supraclavicular Block

Comparison of Plexus Brachial Blockade Effect by Supraclavicular and Axillary Approach - our Experience

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