Ultrasound does not shorten the duration of procedure but provides a faster sensory and motor block onset in comparison to nerve stimulator in infraclavicular brachial plexus block / 대한마취과학회지

BACKGROUND: Infraclaviculr Brachial plexus (ICBP) block is useful for upper extremity surgery. The aim of this study was to compare the ultrasound (US) technique with the nerve stimulation (NS) technique in their success rates and times to perform ICBP block. METHODS: 60 patients undergoing surgery of the upper limb were randomly allocated into two groups (n = 30 per group). Group 1; US, and Group 2; NS. Procedure time (including time for initial ultrasound examination), the success rate and the onset time of sensory and motor blockade were assessed. RESULTS: The time needed to perform the ICBP block is similar in both groups (220 seconds +/- 130 in US group versus 281 +/- 134 seconds in NS group; P = 0.74). The success rate of all the nerve blocks in the US group was 100%. The success rate in the NS group was 73.3%, 76.7%, 76.7% and 100% for radial, ulnar, medial, and musculocutaneous nerve, respectively. A significantly faster onset of sensory block for the radial, ulnar, median, musculocutaneous, and the four nerves considered together were observed. The onset of motor block for the radial, ulnar, and medial nerves was faster in the US group. However, the onset of motor block for the musculocutaneous nerve and the four nerves considered together was comparable between the two groups. CONCLUSIONS: The ultrasound-guided infraclavicular brachial plexus block is a significantly efficacious method with faster onset but similar procedure time compared to the nerve stimulation technique.

Effect of intra and postoperative magnesium sulphate infusion on postoperative pain

Evaluate the effect of intra and postoperative magnesium sulphate infusion on postoperative pain in abdominal surgery. Prospective double-blind randomized controlled study. Forty eight patients were randomly allocated to receive in the induction of anaesthesia, intraoperatively and six hours postoperatively either magnesium sulphate M Group [bolus 50mg/kg and 0.5g/h] or placebo [P Group]. Patients were given a dose of morphine [0.l mg/kg] IV, 45min before the end of surgery. Sedation, pain scores, cumulative morphine consumption and adverse effects were recorded up to 24 hours postoperatively. The duration of anaesthesia was similar in both groups. The time of the first demand of morphine was significantly longer in M Group then in P Group, respectively [18 +/- 5min vs 7 +/- lmin, p = 0.03]. Morphine consumption was significantly higher in control group than M group on the first postoperative day [52 +/- 4mg vs 30 +/- 3mg, p = 0.0002]. Pain scores were significantly lower in M group than in P group. Serum magnesium concentration was significantly higher in the M group. The frequency of side effects was similar in the two groups. The results of the study support magnesium sulphate as useful adjuvant for postoperative analgesia in abdominal surgery