Adenosine and Magnesium Sulphate Vs Bupivacaine in Infraclavicular Infusion for Upper Limb Surgeries and Post-Operative Analgesia: A Prospective Study
DOI:
https://doi.org/10.21276/kmbt6x33Keywords:
Bupivacaine, Adenosine, Magnesium Sulfate, Brachial plexus block.Abstract
Background: Brachial plexus piece has reformed the field of regional anesthesia for upper limb surgeries. Infraclavicular subcoracoid approach gives complete block without significant difficulties. Aim: To compare the additives adenosine and magnesium sulphate with bupivacaine in infraclavicular infusion for upper limb surgeries and postoperative analgesia.
Methods: This Prospective study was done at the Department of Anaesthesiology, Pacific Medical College and Hospital, Udaipur, Rajasthan. Around 30 patients scheduled for elective unilateral upper limb surgeries involving distal arm/ elbow/ forearm/hand divided into two groups A (n-15) and B (n-15) 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: Result s showed that 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.
Conclusions: The addition of magnesium sulphate as an additive to bupivacaine in brachial plexus block may be a better choice when prolonged postoperative analgesia is required.
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References
Sandhu NS, Capan LM. Ultrasound-guided infraclavicular brachial plexus block. Br J Anaesth.2002;89:254-9.
Apan A, Ozcan S, Buyukkocak U, Anbarci O, Basar H. Perioperative intravenous adenosine infusion to extend postoperative analgesia in brachial plexus block. Eur J Anaesthesiol. 2003;20:916-9.
Dogru K, Yildirim D, Ulgey A, Aksu R, Bicer C, Boyaci A. Adding magnesium to levobupivacaine for axillary brachial plexus block in arteriovenous fistule surgery. Bratisl Lek Listy. 2012;113:607-9.
Choi IG, Choi YS, Kim YH, Min JH, Chae YK, Lee YK, et al. The Effects of Postoperative Brachial Plexus Block Using MgSO (4) on the Postoperative Pain after Upper Extremity Surgery. Korean J Pain. 2011;24:158-63
Fukunaga AF, Alexander GE, Stark CW. Characterization of the analgesic actions of adenosine: Comparison of adenosine and remifentanil infusions in patients undergoing major surgical procedures. Pain.2003;101:129-38.
Gan TJ, Habib AS. Adenosine as a non-opioid analgesic in the perioperative setting. Anesth Analg.2007;105:487-94.
Gunduz A, Bilir A, Gulec S. Magnesium added to prilocaine prolongs the duration of axillary plexus block. Reg Anesth Pain Med. 2006;31:233-6.
Mohammed KM, Amnar AS. USG guided continuous infusion in infraclavicular block using bupivacaine alone and combined with adenosine for pain control in upper extremity surgeries. Saudi J anaesth 2011;5(2):132-37.
Ekmekci P, Bengisun ZK, Akan B, Kazbek BK, Ozkan KS, Suer AH. The effect of magnesium added to levobupivacaine for femoral nerve block on postoperative analgesia in patients undergoing ACL reconstruction. Knee Surg Sports Traumatol Arthrosc. 2013;21:1119-24.
Mukherjee K, Das A, Roy S. Evaluation of magnesium as adjunct in ropivacaine induced supraclavicular brachial plexus block-a prospective,double blinded randomised study. J Res Pharm Pract 2014:3(4);123-129.
Apan A, Ozcan S, Buyukkocak U, Anbarci O, Basar H. Perioperative intravenous adenosine infusion to extend postoperative analgesia in brachial plexus block. Eur J Anaesthesiol. 2003;20:916-9.
Lee AR, Yi HW, Chung IS, Ko JS, Ahn HJ, Gwak MS, et al. Magnesium added to bupivacaine prolongs the duration of analgesia after interscalene nerve block. Can J Anaesth. 2012;59:21-7.
Choi IG, Choi YS, Kim YH, Min JH, Chae YK, Lee YK, et al. The Effects of Postoperative Brachial Plexus Block Using MgSO on the Postoperative Pain after Upper Extremity Surgery. Korean J Pain. 2011;24:158-63.
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