Addition of fentanyl to bupivacaine prolongs anesthesia and analgesia in axillary brachial plexus block.
OBJECTIVE
To evaluate the analgesic and anesthetic effects of 40 mL bupivacaine 0.25%, 40 mL bupivacaine 0.25% plus fentanyl 2.5 microg/mL, and 40 mL bupivacaine 0.125% plus fentanyl 2.5 microg/mL for axillary brachial plexus block.


METHODS
Sixty patients were randomly allocated to 3 groups and received axillary brachial plexus block with 40 mL bupivacaine 0.25% (group B), 40 mL bupivacaine 0.25% with fentanyl 2.5 microg/mL (group BF), or 40 mL bupivacaine 0.125% with fentanyl 2.5 microg/mL (group DBF). The onset times and the duration of sensory and motor blocks, duration of analgesia, hemodynamic parameters, and adverse events were noted.


RESULTS
The mean duration of sensory block and analgesia were longer in group BF (10.1 hours and 20.9 hours) than group B (6.9 hours and 11.6 hours) and DBF (5.9 hours and 12.0 hours) (P < .01, P < .001, respectively). The mean duration of motor block was also longer in group BF (10.7 hours) than group B (4.9 hours) (P < .01). Only 2 patients experienced motor block in group DBF. The frequency of successful block was 35% in group DBF (P < .01). Hemodynamic parameters were similar in all groups. In group B, only 1 patient experienced dizziness. Nausea was observed in 1 patient in each fentanyl group.


CONCLUSIONS
The addition of 100 microg/mL fentanyl to 0.25% bupivacaine almost doubles the duration of analgesia following axillary brachial plexus block when compared with 0.25% bupivacaine alone.
Karakaya
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Department of Anesthesiology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey. denizkarakaya@superonline.com
Büyükgöz
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Bariş
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Güldoğuş
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Tür
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D000328:Adult; D000698:Analgesia; D000701:Analgesics, Opioid / Q000494:pharmacology*; D000758:Anesthesia; D000779:Anesthetics, Local / Q000494:pharmacology*; D001365:Axilla; D001917:Brachial Plexus; D002045:Bupivacaine / Q000494:pharmacology*; D005260:Female; D005283:Fentanyl / Q000494:pharmacology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009407:Nerve Block; D013997:Time Factors
D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D005283:Fentanyl; D002045:Bupivacaine