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ORIGINAL ARTICLE
Year : 2018  |  Volume : 31  |  Issue : 1  |  Page : 76-82

Ultrasound-guided double-injection infraclavicular brachial plexus block: Bupivacaine alone or with added dexmedetomidine or fentanyl


Department of Anesthesiology, Faculty of Medicine, Menoufia University Hospital, ShebinEl-Kom, Egypt

Correspondence Address:
Marwa M Al Lahouny
Department of Anesthesiology, Faculty of Medicine, Menoufia University, Shebin El-Kom 32511
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/mmj.mmj_586_16

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Objective The aim of this study was to evaluate the effects of adding dexmedetomidine or fentanyl to bupivacaine in ultrasound-guided infraclavicular block(ICB) for upper limb surgeries. These effects include quality and duration of the analgesia and analgesic consumption. Background ICB provides anesthesia and analgesia to the upper limb. Many adjuvants have been used to improve the quality and duration of analgesia in various nerve blocks. Patients and methods A total of 120 adult patients undergoing elective forearm or hand surgeries received ICB with 27ml of local anesthetic mixture, and were randomly allocated according to the local anesthetic mixture into three groups–groupC(control group)(bupivacaine), groupD (dexmedetomidine)(bupivacaine+dexmedetomidine), and groupF(fentanyl) (bupivacaine+fentanyl). The three groups were compared for the time of onset of sensory and motor blocks, postoperative analgesia, hemodynamic changes, and complications. Results The onset of sensory and motor blockade was significantly more rapid in groupD than in groupsC and F. The duration of sensory and motor blockade was significantly longer in groupD than in the groupsC and F. The duration of analgesia was significantly longer in groupD than in groupsC and F. Heart rate levels were also low in D group compared with groupsC and F during the period of anesthesia. Conclusion We conclude that the addition of dexmedetomidine to a local anesthetic mixture in ultrasound-guided infraclavicular brachial plexus block hastens the onset and prolongs the duration of sensory and motor blocks, as well as the duration of postoperative analgesia, compared with the addition of fentanyl or bupivacaine administration alone.


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