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Abstract
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Background and Aims The dose of local anaesthetics is reduced when using ultrasound (USG) for supraclavicular brachial plexus block (SCBPB). The aim of this study is to observe the clinical effectiveness of combined fentanyl and dexamethasone in 0.5% 9ml bupivacaine with USG and nerve locator guided SCBPB.
Methods This was a prospective double blind randomised control trial. After assessing inclusion and exclusion criteria, total 72 patients were included (gr-a: 36, gr-b: 36). All patients received USG and electrical nerve locator guided SCBPB. Drug was injected with multi-injection technique within the brachial plexus sheath with current intensity 0.3 mA at 0.1 ms duration. Control group (gr-a) received 20 ml 0.5% bupivacaine, Gr-B received 13 ml of drug soup containing 9 ml bupivacaine 0.5%, fentanyl 100 μg, dexamethasone 10 mg. All patient received morphine patient controlled analgesia in postoperative period.
Results Mean time to sensory block was 11.8 minutes (gr-a) and 14.7 minutes (gr-b). Mean time to motor block was 15.6 minutes (gr-a) and 23.5 minutes (gr-b). Mean duration of sensory block was 555.5 minutes (gr-a) and 528.3 minutes (gr-b). Mean duration of motor block was 452.6 minutes (gr-a) and 245.7 minutes (gr-b). Mean morphine requirement in postoperative period 14.2 mg (gr-a) and 8.3 mg (gr-b). Postoperative morphine consumption in first 24 hours was 14.2 mg (gr-a) and 8.3 mg (gr-b).
Time for complete sensory and motor block
Duration of sensory and motor block
Outcome of USG and nerve locator guided supraclavicular brachial plexus block
Conclusions Combined dexamethasone and fentanyl with low volume bupivacaine doesn’t shorten time to block initiation and produce short duration of motor block but reduces postoperative opioid consumption.