Naloxone added to bupivacaine or bupivacaine-fentanyl prolongs motor and sensory block during supraclavicular brachial plexus blockade: a randomized clinical trial.
BACKGROUND
In this study, the effect of naloxone on duration of supraclavicular brachial plexus block was evaluated. It was hypothesized that naloxone can increase the duration of neural blockade.


METHODS
Sixty-eight patients scheduled for surgery under supraclavicular brachial plexus block were randomly assigned to receive 30 ml bupivacaine (Group C); 30 ml bupivacaine with 100 μg of fentanyl (Group F); 30 ml bupivacaine with 100 ng naloxone (Group N); or 30 ml bupivacaine with 100 μg of fentanyl and 100 ng naloxone (Group N + F). Sensory and motor blockade were recorded at 5, 15, and 30 min following the block, and every 10 min following the end of surgery. Duration of sensory and motor block was considered to be the time interval between the complete block and the first postoperative pain and complete recovery of motor functions.


RESULTS
Sensory and motor onset times were the same in all groups. The duration of sensory and motor block in Group C (11.3 ± 1.7 h and 4.56 ± 1.0 h) and Group F (12.8 ± 3.3 h and 5.1 ± 2.0 h) were less than in the other groups (18.1 ± 2.2 h and 6.18 ± 1.0 h in Group N, and 15.8 ± 2.9 h and 6.53 ± 1.1 h in Group N + F, P < 0.0001).


CONCLUSIONS
Addition of naloxone to bupivacaine in supraclavicular brachial plexus block prolonged the duration of the neural blockade.
Department of Anesthesiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
S M
SM
Marashi
Department of Anesthesiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
H R
HR
Sharifnia
Department of Anesthesiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
O
O
Azimaraghi
Department of Anesthesiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Y
Y
Aghajani
Department of Anesthesiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
G
G
Barzin
Department of Anesthesiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
A
A
Movafegh
D000759:Adjuvants, Anesthesia / Q000494:pharmacology; D000328:Adult; D000779:Anesthetics, Local / Q000494:pharmacology; D001917:Brachial Plexus / Q000187:drug effects; D065527:Brachial Plexus Block / Q000379:methods*; D002045:Bupivacaine / Q000494:pharmacology*; D004357:Drug Synergism; D004359:Drug Therapy, Combination; D005260:Female; D005283:Fentanyl / Q000494:pharmacology*; D006801:Humans; D008297:Male; D009043:Motor Activity / Q000187:drug effects; D009270:Naloxone / Q000494:pharmacology*; D009292:Narcotic Antagonists / Q000494:pharmacology; D010149:Postoperative Pain / Q000188:drug therapy*; D013997:Time Factors
D000759:Adjuvants, Anesthesia; D000779:Anesthetics, Local; D009292:Narcotic Antagonists; D009270:Naloxone; D005283:Fentanyl; D002045:Bupivacaine