Naloxone added to bupivacaine or bupivacaine–fentanyl prolongs motor and sensory block during supraclavicular brachial plexus blockade: a randomized clinical trial

Marashi, Sayed Mahdi; Sharifnia, Hamidreza; Azimaraghi, Omid; Aghajani, Yasaman; Barzin, Gilda; Movafegh, Ali

doi:10.1111/aas.12527

Cited by 9 publications

(10 citation statements)

References 31 publications

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“…In association with a recent study, adding a low dose of naloxone (100 ng) to 30 mL of 0.5% bupivacaine (150 mg) prolonged the duration of nerve block during the supraclavicular brachial plexus block . The sensory block duration in patients received 30 mL bupivacaine with 100 ng naloxone was almost 1.6‐folds longer than that in patients received 30 mL bupivacaine alone . This dose of naloxone is less than 0.1% of that used in the present study.…”

Section: Discussionsupporting

confidence: 75%

“…Interestingly, we showed that combined injection of the subthreshold‐dose naloxone with lidocaine displays a supra‐additive analgesic effect. In association with a recent study, adding a low dose of naloxone (100 ng) to 30 mL of 0.5% bupivacaine (150 mg) prolonged the duration of nerve block during the supraclavicular brachial plexus block . The sensory block duration in patients received 30 mL bupivacaine with 100 ng naloxone was almost 1.6‐folds longer than that in patients received 30 mL bupivacaine alone .…”

Section: Discussionmentioning

confidence: 62%

“…The long‐lasting local anesthetic bupivacaine is used for infiltration , but it indeed causes apparent cardiovascular toxicity . Afterward epinephrine , clonidine , or naloxone as an adjuvant was added to local anesthetic preparations for the purpose of prolonged anesthetic duration.…”

Section: Introductionmentioning

confidence: 99%

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Naloxone prolongs cutaneous nociceptive block by lidocaine in rats

Chen

Shieh

Liu

et al. 2017

Fundamemntal Clinical Pharma

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We aimed to investigate the local anesthetic properties of naloxone alone or as an adjunct for the local anesthetic lidocaine. After the block of the cutaneous trunci muscle reflex (CTMR) with drugs delivery by subcutaneous infiltration, cutaneous nociceptive block was tested on the ratsꞌ backs. We demonstrated that naloxone, as well as lidocaine, elicited cutaneous analgesia dose-dependently. The relative potency in inducing cutaneous analgesia was lidocaine [22.6 (20.1 - 25.4) μmol/kg] > naloxone [43.2 (40.3 - 46.4) μmol/kg] (P < 0.05). On an equianesthetic basis [50% effective dose (ED ), ED , and ED ], naloxone displayed a greater duration of cutaneous analgesic action than lidocaine (P < 0.01). Coadministration of lidocaine (ED or ED ) and ineffective-dose naloxone (13.3 μmol/kg) intensifies sensory block (P < 0.01) with prolonged duration of action (P < 0.001) compared with lidocaine (ED or ED ) alone or naloxone (13.3 μmol/kg) alone on infiltrative cutaneous analgesia. The preclinical data showed that naloxone is less potent than lidocaine as an infiltrative anesthetic, but its analgesic duration was longer than that of lidocaine. Furthermore, naloxone prolongs lidocaine analgesia, acting synergistically for nociceptive block.

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Section: Discussionsupporting

confidence: 75%

Section: Discussionmentioning

confidence: 62%

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Naloxone prolongs cutaneous nociceptive block by lidocaine in rats

Chen

Shieh

Liu

et al. 2017

Fundamemntal Clinical Pharma

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“…Naloxone, which gains its popularity as an opioid antagonist, might induce an analgesic effect. Few studies have been published on the use of naloxone for pain relief when added in low dose with LAs in various nerve blockades [5,6,11]. Naloxone produces a dose-dependent pain response; in the rat model, small doses of naloxone produced paradoxical analgesia, while larger doses resulted in hyperalgesia.…”

Section: Discussionmentioning

confidence: 99%

“…Naloxone, which is known as an opioid antagonist, used to counter the effects of opioid overdose, has been used in low dose as an additive to LA drugs to prolong sensory and motor nerve blocks in supraclavicular brachial plexus blockade and peribulbar anesthesia [5,6].…”

Section: Introductionmentioning

confidence: 99%

Small dose of naloxone as an adjuvant to bupivacaine in intrapleural infiltration after thoracotomy surgery: a prospective, controlled study

Amer

Omara

2019

Korean J Pain

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Background Severe pain always develops after thoracotomy; intrapleural regional analgesia is used as a simple, safe technique to control it. This study was performed to evaluate whether a small dose of naloxone with local anesthetics prolongs sensory blockade. Methods A prospective, randomized double-blinded controlled study was conducted on 60 patients of American Society of Anesthesiologists statuses I and II, aged 18 to 60 years, scheduled for unilateral thoracotomy surgery. After surgery, patients were randomly divided into two groups: through the intrapleural catheter, group B received 30 ml of 0.5% bupivacaine, while group N received 30 ml of 0.5% bupivacaine with 100 ng of naloxone. Postoperative pain was assessed using the visual analog pain scale (VAS). Time for the first request for rescue analgesia, total amount consumed, and incidence of postoperative complications were also recorded. Results The VAS score significantly decreased in group N, at 6 h and 8 h after operation ( P < 0.001 for both). At 12 h after injection, the VAS score increased significantly in group N ( P < 0.001). The time for the first request of rescue analgesia was significantly longer in group N compared to group B ( P < 0.001). The total amount of morphine consumed was significantly lower in group N than in the bupivacaine group ( P < 0.001). Conclusions Addition of a small dose of naloxone to bupivacaine in intrapleural regional analgesia significantly prolonged pain relief after thoracotomy and delayed the first request for rescue analgesia, without significant adverse effects.

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Endogenous Opiates and Behavior: 2015

Bodnar

2017

Peptides

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Naloxone added to bupivacaine or bupivacaine–fentanyl prolongs motor and sensory block during supraclavicular brachial plexus blockade: a randomized clinical trial

Abstract: Addition of naloxone to bupivacaine in supraclavicular brachial plexus block prolonged the duration of the neural blockade.

Cited by 9 publications

References 31 publications

Naloxone prolongs cutaneous nociceptive block by lidocaine in rats

Naloxone prolongs cutaneous nociceptive block by lidocaine in rats

Small dose of naloxone as an adjuvant to bupivacaine in intrapleural infiltration after thoracotomy surgery: a prospective, controlled study

Endogenous Opiates and Behavior: 2015

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