EFFECT OF FENTANYL AS AN ADJUVANT TO LOCAL ANAESTHETICS IN SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK ON DURATION OF POST–OPERATIVE ANALGESIA: A PROSPECTIVE RANDOMISED CLINICAL STUDY.

Dr.Vishwas.G.K; Dr. Kiran.B.R; Dr.Sagar.S.M; Dr.Shivakumar.K.P

Volume : IV, Issue : II, February - 2015

EFFECT OF FENTANYL AS AN ADJUVANT TO LOCAL ANAESTHETICS IN SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK ON DURATION OF POST–OPERATIVE ANALGESIA: A PROSPECTIVE RANDOMISED CLINICAL STUDY.

Dr. Vishwas. G. K, Dr. Kiran. B. R, Dr. Sagar. S. M, Dr. Shivakumar. K. P

Abstract :

OBJECTIVE: Regional blocks as always remain a well-accepted component of comprehensive anesthetic care. Any knowledge acquired in this field should be extended into the postoperative period, which is the period of severe, intolerable pain requiring attention. The addition of opioids in achial plexus block is reported to improve success rate and postoperative analgesia, by some authors, whereas others have found no effect. This prospective clinical study was undertaken to compare the onset, the quality and duration of analgesia with 2% lignocaine with adrenaline- bupivacaine mixture and 2% lignocaine with adrenaline- bupivacaine-fentanyl in supraclavicular achial plexus block. MATERIAL & METHODS: Patients were randomly divided into two groups: group I (control) and group II (study). All the patients were subjected to achial plexus block with supraclavicular approach with all aseptic precautions with a 24-gauge needle, immediately lateral to subclavian artery. After obtaining paraesthesia, drugs were administered as follows: Group I (control): bupivacaine 0.5% 20 mL + lignocaine with adrenaline 2% 20 mL + NS 1 mL Group II (study): bupivacaine 0.5% 20 mL + lignocaine with adrenaline 2% 20 mL + fentanyl 1 mL (50 microgram).Onset of analgesia time, duration of sensory blockade, duration of postoperative analgesia & any side effects were noted. . Rescue analgesia was given when VAS > 4/10 and it was given in the form of Inj.Diclofenac Sodium 1.5 mg/kg intramuscularly. RESULTS: The addition of fentanyl to achial plexus block prolonged the onset of analgesia.The durations of sensory blockade and analgesia were significantly longer in fentanyl Group.There was no statistically significant difference in the incidence of side effects between the two groups. CONCLUSION:Fentanyl as an adjuvant to local anaesthetic solution in supraclavicular achial plexus block can increase the success rate and significantly prolong the duration of analgesia, but it delays the onset time of sensory blockade as compared with that achieved by the same doses of local anesthetics used in combination.