Effect of local and systemic fentanyl on ropivacaine-induced supraclavicular block of brachial plexus

ABSTRACT

This prospective, randomized double blind study was designed to evaluate different effects of the addition of fentanyl to ropivacaine, on the analgesic profile after supraclavicular block of brachial plexus and to assess the hemodynamic effect and complications of this mixture in cases scheduled for elective upper limb orthopedic surgery at Mansoura University Hospitals. Forty five adult patients, ASA I-II, subjected for elective upper limb orthopedic surgery at Mansoura University Hospital were enrolled in this study. The patients were randomly assigned, using sealed envelope method, into 3 groups, each one consisted of 15 patients according to the mixture of anesthetic solution ropivacaine group[R] received 30 ml 0.75% local ropivacaine + 2ml saline i.m, local fentanyl group [FL]received 30 ml 0.75% local ropivacaine mixed with 1 micro g / kg fentanyl + 2 ml saline i.m and systemic fentanyl group [FS] received 30 ml 0.75% local ropivacaine and i.m 1 micro g/kg fentanyl. The previously mentioned injectates were prepared in similar syringes by an Anesthetist other than the anesthesia provider. Parameters of brachial plexus blockade were recorded and included Onset of sensory block, Onset of motor block, Postoperative analgesia duration and duration of anesthesia. Haemodynamic variables [heart rate and arterial blood pressure] and oxygen saturation were recorded. Intraoperative and postoperative complications as cardiovascular, respiratory or neurological disturbance were also recorded. Data were obtained and analyzed using statistica program. In this study, we recorded no effect on the duration of anesthesia or the duration of postoperative analgesia after addition of perineural fentanyl. But, we recorded a delay in the onset of anesthesia which occurred only with perineural fentanyl. We did not record any cardiovascular, respiratory or neurological complications. As regards our conclusions concerning effect of adding1 micro g /kg fentanyl to ropivacaine in supraclavicular brachial plexus blockade, we assumed that addition of perineural fentanyl was of no benefit as regards the duration, quality of anesthesia and postoperative analgesia