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The Effect of Adding Sufentanil to 0.5% Hyperbaric Bupivacaine on Duration of Brachial Plexus Blockade in Chronic Opium Abusers: a Randomized Clinical Trial.

Azimaraghi O, Marashi SM, Khazaei N, Pourhassan S, Movafegh A - Anesth Pain Med (2015)

Bottom Line: An ultrasound-guided technique was applied to perform upper extremity brachial plexus blockade.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.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology, Pain and Critical Care, Dr. Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.

ABSTRACT

Background: Anesthesia induction in patients with current substance abuse can be a challenge for anesthesiologists.

Objectives: This study aimed to evaluate the effect of adding Sufentanil to Bupivacaine on duration of brachial plexus nerve block.

Patients and 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.

No MeSH data available.


Related in: MedlinePlus

Duration and Onset of Sensory and Motor Nerve BlocksGroup A had no history of chronic opium use and received 30 mL hyperbaric bupivacaine along with 2 mL saline as placebo. Group B had no history of opium use and received 30 mL hyperbaric bupivacaine along with 2 mL sufentanil. Group C had a positive history of chronic opium use and received 30 mL hyperbaric bupivacaine along with 2 mL saline as placebo. Group D had a positive history of chronic opium use and received 30 mL hyperbaric bupivacaine along with 2 mL sufentanil (10 µg).
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fig20207: Duration and Onset of Sensory and Motor Nerve BlocksGroup A had no history of chronic opium use and received 30 mL hyperbaric bupivacaine along with 2 mL saline as placebo. Group B had no history of opium use and received 30 mL hyperbaric bupivacaine along with 2 mL sufentanil. Group C had a positive history of chronic opium use and received 30 mL hyperbaric bupivacaine along with 2 mL saline as placebo. Group D had a positive history of chronic opium use and received 30 mL hyperbaric bupivacaine along with 2 mL sufentanil (10 µg).

Mentions: The duration of sensory and motor block time was shortest 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) versus group C (537.0 ± 40.1 minutes, 479.0 ± 34.8 minutes) (P < 0.001, one-way ANOVA) (Figure 2). There were no significant differences in onset of sensory and motor block in Groups A, B, C and D (Tukey post hoc test). Interestingly, the duration of sensory and motor block time between group A and D was not statistically significant. The sensory and motor onset times were not statistically different between the groups.


The Effect of Adding Sufentanil to 0.5% Hyperbaric Bupivacaine on Duration of Brachial Plexus Blockade in Chronic Opium Abusers: a Randomized Clinical Trial.

Azimaraghi O, Marashi SM, Khazaei N, Pourhassan S, Movafegh A - Anesth Pain Med (2015)

Duration and Onset of Sensory and Motor Nerve BlocksGroup A had no history of chronic opium use and received 30 mL hyperbaric bupivacaine along with 2 mL saline as placebo. Group B had no history of opium use and received 30 mL hyperbaric bupivacaine along with 2 mL sufentanil. Group C had a positive history of chronic opium use and received 30 mL hyperbaric bupivacaine along with 2 mL saline as placebo. Group D had a positive history of chronic opium use and received 30 mL hyperbaric bupivacaine along with 2 mL sufentanil (10 µg).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4493736&req=5

fig20207: Duration and Onset of Sensory and Motor Nerve BlocksGroup A had no history of chronic opium use and received 30 mL hyperbaric bupivacaine along with 2 mL saline as placebo. Group B had no history of opium use and received 30 mL hyperbaric bupivacaine along with 2 mL sufentanil. Group C had a positive history of chronic opium use and received 30 mL hyperbaric bupivacaine along with 2 mL saline as placebo. Group D had a positive history of chronic opium use and received 30 mL hyperbaric bupivacaine along with 2 mL sufentanil (10 µg).
Mentions: The duration of sensory and motor block time was shortest 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) versus group C (537.0 ± 40.1 minutes, 479.0 ± 34.8 minutes) (P < 0.001, one-way ANOVA) (Figure 2). There were no significant differences in onset of sensory and motor block in Groups A, B, C and D (Tukey post hoc test). Interestingly, the duration of sensory and motor block time between group A and D was not statistically significant. The sensory and motor onset times were not statistically different between the groups.

Bottom Line: An ultrasound-guided technique was applied to perform upper extremity brachial plexus blockade.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.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology, Pain and Critical Care, Dr. Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.

ABSTRACT

Background: Anesthesia induction in patients with current substance abuse can be a challenge for anesthesiologists.

Objectives: This study aimed to evaluate the effect of adding Sufentanil to Bupivacaine on duration of brachial plexus nerve block.

Patients and 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.

No MeSH data available.


Related in: MedlinePlus