A Comparative Study on the Effects of Adding Fentanyl and Buprenorphine to Local Anaesthetics In Brachial Plexus Block 3337-3343
Dr Gurjeet Khurana
Department of Anaesthesia
Himalayan Institute of Medical Sciences
Jolly Grant Dehradun
e-mail id.- firstname.lastname@example.org
Objective: To evaluate the efficacy of fentanyl and buprenorphine in improving the blockade characteristics when used as an additives in supraclavicular block.
Study Design: Prospective, randomized, double blind trial conducted over a period of twelve months (July 09- June 10).
Material and Methods: A total 75 adult patients of either sex with ASA health status I-III, who were selected for elective upper limb surgery under supraclavicular brachial plexus block were randomly divided into three equal Groups A, B and C. Group A received a mixture of lignocaine (2%) with adrenaline (1:2,00,000) 10ml + bupivacaine (0.5%) 20 ml + distilled water 10 ml, to make a total volume of 40 ml. Group B received 1 ml (0.3 mg) buprenorphine and Group C received 1ml (50 µgm) fentanyl in addition to the above local anaesthetics in the same volumes and concentrations. The onset time of the sensory and motor blocks; the time required for complete sensory and motor blocks; the total duration of analgesia, the haemodynamic changes and side effects were noted and compared in both the groups.
Results: The onset time of the sensory and motor blocks was delayed in the fentanyl group (4.4 ± 1.41 min and 3.04 ± 1.31 min respectively), with no significant benefits on the duration of analgesia. In group C, buprenorphine, when added to local anaesthetics, prolonged the duration of analgesia by more than 1.5 times as compared to group A. Addition of fentanyl and buprinorphine to local anaesthetics in the brachial plexus block had no significant effects on the respiratory and haemodynamic parameters, except with minimal incidence (5.33%) of nausea and vomiting with the use of buprenorphine.
Conclusion: We conclude that the addition of buprenorphine to local anaesthetics provides long lasting analgesia without any significant increase in complications and recommend its incorporation in the routine anaesthesia practice.