Use of Bupivacaine with Additives Adenosine and Magnesium Sulphate for Upper Limb Surgeries: A Prospective Comparative Study in a Tertiary Care Hospital
Background: Brachial plexus square has altered the field of regional anesthesia for upper appendage surgeries. Infraclavicular subcoracoid approach gives finish obstruct without real intricacies. Point: To analyze the added substances adenosine and magnesium sulfate with bupivacaine in infraclavicular implantation for upper appendage surgeries and postoperative absense of pain. Methods: This prospective study was conducted in the department of Anaesthesiology at Maharishi Markandeshwar Medical College & Hospital, Solan, H.P. 20 patients scheduled for elective unilateral upper limb surgeries involving distal arm/ elbow/ forearm/hand divided into two groups A (n-10) and B (n-10) randomly. Group A - adenosine 6mgs with 28 ml 0.5% bupivacaine bolus followed by infusion of 0.25% bupivacaine 28ml with 6mgs of adenosine (2ml) at a rate of 5ml/hr. Group B -magnesium sulphate 75 mgs (in 2ml) with 28ml of 0.5% bupivacaine bolus followed by infusion of 0.25% bupivacaine 28ml with 75mgs of magnesium sulphate (in 2ml) at a rate of 5ml/hr in USG guided placement of infraclavicular catheter. Results: Statistical analysis showed Group A had a faster onset time of sensory and motor block and faster recovery when compared to group B. Group A needed more rescue analgesia than group B. Though Group B had a higher incidence of sedation and vomiting than group A, it was not significant. Conclusion: Though the addition of adenosine and magnesium sulphate to bupivacaine as additive gives prolonged analgesia, magnesium sulphate exceeds adenosine in achieving prolonged postoperative analgesia and better pain score and may be a better choice than adenosine.
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