ABSTRACT
INTRODUCCIÓN: El bloqueo del plexo braquial (BPB)por vía axilar es un procedimiento anestésico habitual.La adición de variados fármacos coadyuvantes se hamostrado efectiva en la mejoría de los resultados conesta técnica. Este estudio evalúa la incorporación debicarbonato de sodio y/o clonidina al BPB con mepivacaína.MATERIAL Y MÉTODO: Se realizó un estudio controladorandomizado de 60 pacientes, entre 18 y 70 años, ASA 1a 3 estables, que recibieron anestesia con técnica deBPB. Se dividieron en 4 grupos de 15 pacientes: GrupoI (control) recibió 40 mL de mepivacaína (MEP) 1% conadrenalina (A) + 5 mL de suero fisiológico (SF); el GrupoII, 40 mL MEP 1% con A + 4 mL NaHCO3 + 1 mLSF; el Grupo III, 40 mL MEP 1% con A + 150 µg clonidina+ 4 mL SF y el Grupo IV, 40 mL MEP 1% con A +4 mL NaHCO3 + 150 µg de clonidina.RESULTADOS: El tiempo de instalación del BPB fue significativamentemenor en los grupos II y IV. La duracióndel BPB fue mayor en el grupo III, la analgesia obtenidaen el grupo 3 fue significativamente mayor.CONCLUSIONES: La adición de bicarbonato de sodio ala mepivacaína disminuye el tiempo de latencia del BPBpor vía axilar, la incorporación de clonidina prolonga laduración de la anestesia y analgesia, la adición conjuntade bicarbonato de sodio y clonidina reduce el tiempo delatencia pero no incrementa la duración de la anestesiay analgesia
BACKGROUND AND OBJECTIVE: The axillary brachialplexus block is a frequently performed anesthetic technique.Adding a variety of coadjuvant drugs has beenshown to improve results. This study evaluated the additionof sodium bicarbonate (NaHCO3) and/or clonidineto mepivacaine for performing the block.MATERIAL AND METHODS: Sixty patients between 18and 70 years old, ASA 1-3 in stable condition receivedaxillary brachial plexus blocks in a randomized controlledstudy. Four groups of 15 patients each were formed:group I (control group) received 40 mL of 1% mepivacainewith adrenaline plus 5 mL of saline; group II, 40mL of 1% mepivacaine with adrenaline plus 4 mL ofNaHCO3 and 1 mL of saline; group III, 40 mL of 1%mepivacaine with 150 µg of clonidine plus 4mL of saline;and group IV, 40 mL of 1% mepivacaine with adrenalineplus 4 mL of NaHCO3 and 150 µg of clonidine.RESULTS: The onset time was significantly shorter ingroups 2 and 4. The duration of the block was longer ingroup 3 and the analgesic effect was significantlybetter.CONCLUSIONS: Adding NaHCO3 to mepivacaine shortensthe time of onset of an axillary brachial plexus block.Including clonidine prolongs the duration of anesthesiaand analgesia. The addition of both NaHCO3 and clonidineshortens time to onset but does not prolong durationof anesthesia or analgesia
Subject(s)
Male , Female , Adolescent , Adult , Middle Aged , Aged , Humans , Anesthetics/administration & dosage , Brachial Plexus , Nerve Block , Pain, Postoperative/prevention & control , Clonidine/administration & dosage , Mepivacaine/administration & dosage , Sodium Bicarbonate/administration & dosage , Double-Blind Method , Prospective Studies , Treatment Outcome , Hand/surgery , Drug InteractionsABSTRACT
BACKGROUND AND OBJECTIVE: The axillary brachial plexus block is a frequently performed anesthetic technique. Adding a variety of coadjuvant drugs has been shown to improve results. This study evaluated the addition of sodium bicarbonate (NaHCO3) and/or clonidine to mepivacaine for performing the block. MATERIAL AND METHODS: Sixty patients between 18 and 70 years old, ASA 1-3 in stable condition received axillary brachial plexus blocks in a randomized controlled study. Four groups of 15 patients each were formed: group I (control group) received 40 mL of 1% mepivacaine with adrenaline plus 5 mL of saline; group II, 40 mL of 1% mepivacaine with adrenaline plus 4 mL of NaHCO3 and 1 mL of saline; group III, 40 mL of 1% mepivacaine with 150 microg of clonidine plus 4mL of saline; and group IV, 40 mL of 1% mepivacaine with adrenaline plus 4 mL of NaHCO3 and 150 microg of clonidine. RESULTS: The onset time was significantly shorter in groups 2 and 4. The duration of the block was longer in group 3 and the analgesic effect was significantly better. CONCLUSIONS: Adding NaHCO3 to mepivacaine shortens the time of onset of an axillary brachial plexus block. Including clonidine prolongs the duration of anesthesia and analgesia. The addition of both NaHCO3 and clonidine shortens time to onset but does not prolong duration of anesthesia or analgesia.
