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23 Supraclavicular block for elbow fractures
  1. W Kamal
  1. Elyoussef Medical Teaching Hospital, Military Central Hospital, Akkar, Lebanon


Background and Aims The aim is to demonstrate the efficiency of supraclavicular block with a mixture of Bupivicaine 0.5% and lidocaine 2%.

Methods Patients with elbow fractures were scheduled for supraclavicular block using a mixture (50/50) of bupivicaine 0.5% and lidocaine 2%. The volume used was 40 ml. Dexamethasone 8 mg was added i. V. It was opened surgery with insertion of 2 plaques with screws. Duration of operations was 2–3 hours. Some patients who were put in sitting position received an intubation with 50mcg fentanyl, propofol 150 mg, rocuronium 30 mg, and the maintenance was on sevoflurane 1%, with oxygene/air(50/50). Patients that were put laterally received midazolam 1–3 mg iv, snd 50–70 mg propofol and maintained on spontaneous respiration on oxygen mask.

Results Perioperatively, the pulse, heart rate and pressure did not change more then 20%. Patients were stable hemodynamically. They were sent to the recovery room to be observed for 30 min and tben transferred to the wards. They received paracetamol 1g iv/6h and ketorolac 30 mg iv/8h. The EVA was always <4. They went home on the next day.

Conclusions A mixture of bupivicaine 0.5% isobar with lidocaine 2%, with a total volume of 40 ml and dexamethasone 8 mg iv, gives adequate analgesia and anesthesia for elbows fractures that were operated by insertion of plaques.

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