Adenosine and Magnesium Sulphate Vs Bupivacaine in Infraclavicular Infusion for Upper Limb Surgeries and Post-Operative Analgesia: A Prospective Study
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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