Fentanyl does not improve the nerve block characteristics of axillary brachial plexus anaesthesia performed with ropivacaine

Fanelli, Guido; Casati, Andrea; Magistris, L.; Berti, Marco; Albertin, A.; Scarioni, Monica; Torri, G.

doi:10.1034/j.1399-6576.2001.045005590.x

Cited by 49 publications

(23 citation statements)

References 19 publications

(33 reference statements)

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“…Previous studies have reported improved analgesia following the addition of fentanyl to LAs in various nerve blocks, including the axillary brachial plexus (9,10), cervical plexus (11), infraorbital nerve (12), caudal block (13) and paravertebral analgesia (14). Conversely, other studies (15)(16)(17) have been unable to detect improved analgesia following co-administration of LAs and fentanyl. The conflicting findings of previous studies may be due to differences in the concentrations and doses used, as well as due to methodological differences in the study design, including a lack of systemic control groups, and the site and technique of nerve blocks.…”

Section: Discussionmentioning

confidence: 70%

“…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: 98%

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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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Section: Discussionmentioning

confidence: 70%

Section: Introductionmentioning

confidence: 98%

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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“…Although the predominant site of opioid action lies within the central nervous system, µ opioid receptors have been located on peripheral nerve terminals [31]. Despite this finding, conflicting data exist whether the addition of opioids to a continuous infusion formula improves the pain relief provided by peripheral nerve catheters [32,33].…”

Section: Discussionmentioning

confidence: 99%

Continuous peripheral nerve blocks

Shinaman¹,

Mackey

2005

Current Science Inc

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Sophisticated regional anesthesia techniques have experienced substantial growth throughout the past 5 years for acute and chronic pain management. The recognition that regional anesthesia leads to superior postoperative outcomes in acute pain management and to an increased understanding of the pathogenesis of chronic pain has led to increased use of continuous peripheral nerve catheters. Furthermore, the availability of new equipment and techniques specifically designed to facilitate effective catheter placement has increased interest and adoption of peripheral nerve catheters to manage painful conditions. This has become particularly relevant as the scope of ambulatory surgery continues to grow. To maximize success rates with continuous peripheral nerve catheters, clinicians must be intimately aware of the pertinent regional anatomy and technical issues surrounding placement and maintenance of continuous nerve blockade. The recent development of outpatient infusion systems and novel anesthetics has been exciting and is likely to lead to an increase in the use of continuous peripheral catheter techniques. The consistent recognition that these techniques dramatically increase patient satisfaction should dictate an increasing presence in the field of pain management throughout the next several years.

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“…It failed to change the quality of blockade and to prolong postoperative analgesia when added to mepivacaine for brachial plexus block (Morros et al, 1991; Kardash et al, 1995). Fanelli et al (2001) demonstrated that the addition of fentanyl to ropivacaine did not improve the nerve block characteristics of axillary brachial plexus anesthesia.…”

Section: Clinical Pharmacology Of Drugs Used In Ramentioning

confidence: 95%

Efficacy of drugs in regional anesthesia: A review

Allegri

Delazzo

Grossi

et al. 2009

Eur Journal of Pain Supp

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Local anesthetics and opioids are the most commonly used drugs in regional anesthesia. Several other drugs are used as adjuvants in addition to local anesthetics. We will review the drugs currently used in regional anesthesia. In April 2009 we searched the PubMed database and found 143 articles related to the clinical use of drugs in regional anesthesia; we divided them into 3 major chapters: local anesthetics, opioids and adjuvants. Among local anesthetics, ropivacaine and levobupivacaine can be considered the drugs of choice in neuraxial and peripheral techniques because their toxicity is low even in large volume administration; mepivacaine can be considered the drug of choice in peripheral techniques when a shorter blockade is needed. Sufentanil is the opioid of choice in both neuraxial and peripheral techniques because it appears to improve the quality of anesthesia and to prolong sensory blockade in the postoperative period. Among the adjuvants to local anesthetics, clonidine is by far the most used drug in regional anesthesia; its yield in improving and prolonging the effects of local anesthetics is apparent in neuraxial techniques. Other drugs have been studied as adjuvants to local anesthetics but clinical evidence of their benefit is controversial in many cases and further trials are unquestionably warranted. In conclusion, since many different drugs are available for regional anesthesia, we must choose wisely the one that exhibits the best safety‐efficacy profile and that suits the chosen technique and type of anesthesia/analgesia best.

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Fentanyl does not improve the nerve block characteristics of axillary brachial plexus anaesthesia performed with ropivacaine

Abstract: The addition of fentanyl 1 microg. ml-1 to ropivacaine 7.5 mg. ml-1 does not improve the nerve block characteristics of axillary brachial plexus anaesthesia for orthopaedic procedures involving the hand.

Cited by 49 publications

References 19 publications

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

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

Continuous peripheral nerve blocks

Efficacy of drugs in regional anesthesia: A review

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