Block characteristics of Dexmedetomidine as an adjuvant to local anaesthetic in Infraclavicular brachial plexus block using peripheral nerve stimulator and ultrasound

2021 ◽  
Vol 23 (2) ◽  
pp. 40-46
Author(s):  
Ujma Shrestha ◽  
Sushila Lama Moktan ◽  
Sanjay Shrestha
Keyword(s):  
Peripheral Nerve ◽  
Brachial Plexus ◽  
Brachial Plexus Block ◽  
Sensory Block ◽  
Local Anaesthetics ◽  
Nerve Stimulator ◽  
Ultrasound Guided ◽  
Peripheral Nerve Stimulator ◽  
Infraclavicular Brachial Plexus Block ◽  
Plexus Block

Introduction: Dexmedetomidine has been frequently used in regional anaesthesia to improve the quality of blocks. Addition of dexmedetomidine to local anaesthetics has been shown to hasten the onset of both sensory and motor blocks and also prolong the duration of analgesia. The objective of this prospective comparative study was to assess the change in characteristics of infraclavicular brachial plexus block after adding Inj. Dexmedetomidine to 2% Lignocaine with Adrenaline. Methods: Sixty-six patients, scheduled for upper limb surgeries under ultrasound guided infraclavicular brachial plexus block were randomly allocated to two groups. Group LS received Inj. Lignocaine 2% with Adrenaline, 7mg/kg diluted to 30 ml with saline and Group LD received Inj. Dexmedetomidine 0.75 mcg/kg in addition to Inj. Lignocaine 2% with Adrenaline, 7mg/kg again diluted to a total volume of 30 ml. The parameters studied were: onset of sensory and motor blocks and duration of analgesia. Results: Sixty patients completed the study. The demographic variables and motor block were similar between both groups. The mean time to onset of sensory block was significantly faster in Group LD compared to Group LS (9.80±4.85 min vs 12.30±3.97 min, p=0.033). The duration of analgesia was also found to be prolonged in Group LD compared to Group LS (286.73±55.38 min vs 226.53±41.19 min, p < 0.001). Conclusion: Addition of 0.75 mcg/kg of Dexmedetomidine to 2% Lignocaine with Adrenaline hastens the onset of sensory block and prolongs the duration of analgesia in ultrasound guided and peripheral nerve stimulator guided infraclavicular block.

scholarly journals Ultrasound guided interscalene brachial plexus block via lower approach for upper limb surgeries

2018 ◽  
Vol 5 (5) ◽  
pp. 1304
Author(s):  
Roopal R. Garaniya ◽  
Sheetal Shah ◽  
Noopur Prajapati
Keyword(s):  
Peripheral Nerve ◽  
Brachial Plexus ◽  
Ulnar Nerve ◽  
Upper Limb ◽  
Brachial Plexus Block ◽  
Interscalene Block ◽  
Ultrasound Guided ◽  
Peripheral Nerve Stimulator ◽  
Interscalene Brachial Plexus Block ◽  
Plexus Block

Background: Brachial plexus block via interscalene approach is an excellent option for upper limb surgeries, but due to sparing of ulnar nerve (lower trunk, C8-T1) and its’ complications, it is not so popular. To overcome this problem, interscalene block via lower approach has been tried which has more advantage in view of ulnar nerve blockage and also less complications. In addition, ultrasound provides reliability, ease, rapidity and also patient comfort during block procedure. This prospective study was performed to evaluate the anaesthetic effect of lower approach interscalene block with the help of ultrasound and peripheral nerve stimulator.Methods: Ultrasound guided interscalene brachial plexus block via lower approach was given in randomly selected 30 patients, undergoing upper limb orthopaedic surgeries. After localisation of brachial plexus with ultrasound, the nerve roots were confirmed with the help of peripheral nerve stimulator, before injecting drug. At 5 and 15 min after block, all patients were assessed for the effect. Postoperatively they were assessed for any complication and also for their satisfaction level by Likert’s scale.Results: In territories of ulnar, radial and musculocutaneous nerve there was 100% effect while in median nerve territory 92.8% motor block was there. There was no need of analgesics during intra operative period in any patient and there were no major complications with this approach.Conclusions: Ultrasound guided interscalene block via lower approach is an excellent alternative for upper limb surgeries over classical approach in view of ulnar nerve blockage without any major complication.

scholarly journals Peripheral Nerve Stimulator (PNS) Versus Trans-Arterial (TA) Techniques for Axillary Brachial Plexus Block

2021 ◽  
Vol 6 (1) ◽  
pp. 21-26
Author(s):  
Sunil Kumar Sah ◽  
Tofazzel Haque Sahana ◽  
Sekhar Ranjan Basu
Keyword(s):  
Peripheral Nerve ◽  
Brachial Plexus ◽  
Success Rate ◽  
Brachial Plexus Block ◽  
Randomized Study ◽  
Nerve Stimulator ◽  
Peripheral Nerve Stimulator ◽  
Axillary Brachial Plexus Block ◽  
Significant Difference ◽  
Plexus Block

Background: Axillary brachial plexus block is one of the widely used techniques for upper extremity surgery. Peripheral nerve blocks (PNB) provide optimal surgical conditions while providing prolonged post-operative analgesia. The transarterial (TA) technique of axillary brachial plexus block is a well established method of producing regional anaesthesia for surgeries at or below elbow. In this prospective randomized study we compared, “peripheral nerve stimulator (PNS) versus trans-arterial (TA) techniques for axillary brachial plexus block” Methods: In this prospective, randomized study 80 patients, age>18 year, ASA-I & II, were divided randomly into two groups PNS and TA. In PNS groups 40 patients received axillary approach of brachial plexus block with the help of peripheral nerve stimulator, and rest TA group received axillary block through transarterial approach. Local anaesthetic 0.25% bupivacaine 15ml+1% lignocaine with adrenaline (1:200,000) 20 ml was used. Then success rate of two different methods of block were compared. Other parameters of comparison was block performance time of block, onset of sensory and motor block, failure rate, analgesia required etcetera. Results: The success rate of the block in PNS group was 90% and the success rate of TA group was 85% and there was no significant difference in success rate. Performance time was significantly low in trans-arterial axillary approach of brachial plexus block (p<0.005). There was no significant difference in onset of motor and sensory block. The sensory and motor functions returned properly in all patients. Conclusion: In our study we found that the PNS guided axillary block and TA injection axillary brachial plexus block provide similar success rate, and onset of block when musculocutaneous nerve blocked separately in the both techniques. Keywords: Axillary brachial plexus block, Trans-arterial approach, Peripheral nerve stimulator.

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