title: The Effect of Adding Sufentanil to 0.5% Hyperbaric Bupivacaine on Duration of Brachial Plexus Blockade in Chronic Opium Abusers: a Randomized Clinical Trial.
abstract: BACKGROUND
  Anesthesia induction in patients with current substance abuse can be a challenge for anesthesiologists.
  
  
  OBJECTIVE
  This study aimed to evaluate the effect of adding Sufentanil to Bupivacaine on duration of brachial plexus nerve block.
  
  
  METHODS
  One hundred and twenty patients with (Groups C and D) and without (Groups A and B) a history of opium abuse (60 in each group) scheduled for elective upper extremity procedures were randomly assigned to either receive 30 mL bupivacaine alone (Groups A and C) or in combination with additional 10 µg sufentanil (Groups B and D). An ultrasound-guided technique was applied to perform upper extremity brachial plexus blockade. The onset and duration of sensory and motor blocks were recorded and compared between the four groups.
  
  
  RESULTS
  The duration of sensory and motor block were significantly less in Group C (537.0 ± 40.1 minutes, 479.0 ± 34.8 minutes) and the longest duration of sensory and motor block was observed in group B (705.0 ± 43.8 minutes, 640.0 ± 32.5 minutes). The duration of sensory and motor block in Group B (705.0 ± 43.8 minutes, 640.0 ± 32.5 minutes) was longer and statistically higher than group A (619.5 ± 48.0 minutes, 573.2 ± 31.5 minutes), the same trend was observed in group D (598.6 ± 53.2 minutes, 569.3 ± 39.9 minutes) over group C (537.0 ± 40.1 minutes, 479.0 ± 34.8 minutes) (P < 0.001, one-way ANOVA).
  
  
  CONCLUSIONS
  The length of sensory and motor blockade is shorter in chronic opioid abusers. Adding 10 µg sufentanil to hyperbaric bupivacaine in opium abusers lengthened the sensory and motor block duration.
authors.affiliation: Department of Anesthesiology, Pain and Critical Care, Dr. Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Omid
authors.initials: O
authors.lastname: Azimaraghi
authors.affiliation: Department of Anesthesiology, Pain and Critical Care, Dr. Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Seyed Mojtaba
authors.initials: SM
authors.lastname: Marashi
authors.affiliation: Department of Anesthesiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Noushin
authors.initials: N
authors.lastname: Khazaei
authors.affiliation: Department of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Sarah
authors.initials: S
authors.lastname: Pourhassan
authors.affiliation: Department of Anesthesiology, Pain and Critical Care, Dr. Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Movafegh
keywords: Bupivacaine; Nerve Block; Substance-related Disorders; Sufentanil