title: Onset Time of 2% Lidocaine and 0.5% Bupivacaine Mixture versus 0.5% Bupivacaine Alone using Ultrasound and Double Nerve Stimulation for Infraclavicular Brachial Plexus Anesthesia in ESRD Patients Undergoing Arteriovenous Fistula Creation.
abstract: OBJECTIVE
  To reduce the onset of 0.5% bupivacaine by adding 2% lidocaine with 0.5% bupivacaine for ultrasound-guided and double stimulation technique at musculocutaneous and radial nerve for infraclavicular brachial plexus block.
  
  
  METHODS
  Prospective randomized double-blinded, controlled trial study.
  
  
  METHODS
  90 patients undergoing creation of arteriovenous fistula under ultrasound-guided infraclavicular brachial plexus block were randomized into 2 groups. Gr B (46 patients) received 0.5% bupivacaine 30 mL and Gr BL (44 patients) received mixture of 0.5% bupivacaine 20 mL and 2% lidocaine 10 mL. The onset of sensory block were assessed by response to pinprick (grading: 0 = no sensation, 1 = hypoesthesia, and 2 = normal sensation). Rescue analgesia during the operation, duration of sensory and motor blockade were recorded. Surgeon and patient satisfactions are also evaluated using 6-point scale (0 = dissatisfied to 5 = very satisfied).
  
  
  RESULTS
  There were no significant difference in the onset time of either group. Duration of sensory and motor block was not different. Surgeons' and patients' satisfaction were also not significantly different between the groups.
  
  
  CONCLUSIONS
  Mixing 2% lidocaine with 0.5% bupivacaine to the final concentration of 0.67%for lidocaine and 0.33% for bupivacaine does not reduce the onset of ultrasound-guided infraclavicular brachial plexus block.
authors: Orawan
authors: O
authors: Pongraweewan
authors: Nipa
authors: N
authors: Inchua
authors: Chanatthee
authors: C
authors: Kitsiripant
authors: Benchawan
authors: B
authors: Kongmuang
authors: Wannapa
authors: W
authors: Tiwirach
mesh_terms: D000328:Adult; D000779:Anesthetics, Local / Q000008:administration & dosage*; D001166:Arteriovenous Shunt, Surgical; D065527:Brachial Plexus Block / Q000379:methods*; D002045:Bupivacaine / Q000008:administration & dosage*; D004311:Double-Blind Method; D004558:Electric Stimulation; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000601:surgery*; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013997:Time Factors; D018084:Ultrasonography, Interventional
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine; D002045:Bupivacaine