جستجوی مقالات مرتبط با کلیدواژه « بلوک آگزیلاری » در نشریات گروه « پزشکی »

Studies examining the benefit of adding analgesic to brachial plexus block have produced mixed results. We compared the onset, quality and duration of analgesia produced by lidocaine, either alone or combined with sufentanil. A prospective, randomized double blind study was conducted 32 patients scheduled to undergo surgery for upper limb under axillary block. Patients were divided to two groups: those received 40 cc lidocaine 1.5% with 10 g sufentanil (sufentanil group) or 40 cc lidocaine 1.5% with the normal saline (control group). Onset time and duration of sensory and motor block, quality of analgesia and offset time of analgesia were recorded. Demographic data such as weight and gender were identical in both groups. Onset time of sensory and motor block were identical in both groups (p>0.05). Duration of analgesia was significantly shorter in sufentanil group (21017.51 min) than control group (237.1919.23 min) (p<0.001). There was no difference in visual analogue scale (VAS) in both groups (p>0.05). Incidence of nausea and vomiting was greater in sufentanil group (43.75% vs 18.7%). We concluded that addition of 10g sufentanil to 1.5% lidocaine for axillary block did not prolong duration of analgesia and did not improve in onset time and quality of analgesia produced by block. It resulted to increase side effects such as nausea and vomiting.

Studies showed that Verapamil as a calcium channel blocker, potentiates the analgesic effects of local anesthesia; however there is controversy regarding the dosage of Verapamil in this regard. In this study, we evaluated the effect of two doses of Verapamil (5 and 10 mg) in combination with Lidocaine, on quality of local axillary blockage in comparison with placebo. The present study was a double blind placebo –controlled clinical trial. Ninety two patients candidate for upper limb orthopedic and plastic surgery with axillary block were enrolled and divided in three groups randomly. In group A, the patients received only lidocaine 1.5%; in group B, the patients received Verapamil 5 mg plus lidocaine 1.5%; and in group C, the patients received Verapamil 10 mg plus lidocaine 1.5%. Time of onset and duration of analgesia, sympathetic, sensory and motor blocks as well as hemodynamic changes (heart rate, blood pressure and mean arterial pressure) before, during and after surgery were evaluated and compared in the three groups. SPSS V.13, Chi2 and One way ANOVA tests were used for data analysis. P= 0.05 was considered as statistically significant. Systolic, diastolic and mid arterial blood pressures significantly decreased during 15-60 min in both groups receiving Verapamil (5 and 10 mg); after which the blood pressure remained similar in the three groups. Mean onset of sympathetic, sensory and motor block was shorter in patients who received Verapamil (5 and 10 mg) than those who received Lidocaine alone (p<0.001). There was no difference in regard to the onset of sympathetic block in the groups receiving Verapamil (p=0.18). Meanwhile duration of motor and sensory block in Verapamil groups was greater than Lidocaine group. Patients who received Verapamil experienced less post-operative (6 hours) pain than those in placebo group, which was statistically significant. Our finding showed that Verapamil 10 mg could amplify quality of axillary blockage (prolonged duration of analgesia, sensory and motor block and reduced post operation pain) without significant changes in hemodynamic situations in comparison with patient who received Verapamil 5 mg.

Axillary block is used for inducing anesthesia in outpatient hand and forearm surgeries. Few researches have studied hemodynamic and blockade effects of low doses of Epinephrine. The aim of the present study was to compare the duration of analgesia and hemodynamic changes following the injection of high/low epinephrine doses in such surgeries. The present randomized clinical trial study was conducted on healthy individuals (ASA I-II) who were candidates for hand and forearm surgeries.