Comparative study between bupivacaine 0.5% vs. bupivacaine 0.5% plus lidocaine 2% vs. lidocaine 1.5% in ultrasound guided axillary brachial plexus block for brachiocephalic fistula formation in chronic renal failure patients

Anaesthesia, Pain & Intensive Care

article

Ibrahim Salah Mohammed Abdelhady¹  Mahmoud Abdelaziz Ahmed Ghallab¹  Mohamed Sidky Mahmoud Zaki¹  Karim Ahmed Sedky Abdelrahman¹  Amira Fathy Hefni Soliman¹ 

[1] Intensive Care and Pain Management, Faculty of Medicine, Ain Shams University

关键词: Bupivacaine;    Lidocaine;    Hemodialysis;    Brachial plexus block;   

DOI  :  10.35975/apic.v26i6.2055

学科分类：社会科学、人文和艺术（综合）

来源: THK

【 摘 要 】

Background: Patients with chronic renal insufficiency need to have arteriovenous fistula (AVF) for hemodialysis.Ultrasound guided axillary brachial plexus block is a good substitute to general anesthesia or local anesthesia as itcauses vasodilatation and minimum hemodynamic derangement, besides offering prolonged postoperativeanalgesia. We compared three types of local anesthetic solutions; bupivacaine 0.5%, bupivacaine 0.5% plus lidocaine2% and lidocaine 1.5% for onset and duration when used for axillary brachial plexus block.Methodology: Sixty-six patients were randomly allocated to one of the three different groups: Group B: patientsreceived 30 ml of bupivacaine 0.5% for the block; Group BL: received 15 ml of bupivacaine 0.5% with 15 ml lidocaine2% and Group L: received 30 ml of lidocaine 1.5% for the block under US guidance. Onset of sensory and motoranesthesia were registered, and the time to first analgesic demand postoperatively was noted. Statistical analysis ofthe results was undertaken.Results: Results showed that regarding the onset of sensory anesthesia, lidocaine group had the shortest time andthe results were statistically significant compared to the other two groups. A statistically non-significant differencewas found between Group B and Group BL, where Group BL had shorter time of onset than Group B, e.g., 9.05 ±1.36 vs. 9.77 ± 0.97 min. The onset of motor block was the earliest in Group BL and the result was considered nonsignificant between Group L and Group B being shorter in Group L; the difference in results was also non-significantbetween Group BL and Group L. Significantly longer duration of motor and sensory blocks was noted in Group B andcompared to the BL and L groups. As regards the timing of first analgesic need, there was statistically significantdifference between all groups being longest in Group B (608.68 ± 21.74 min)Conclusion: This study revealed that using 30 ml of bupivacaine 0.5% in axillary brachial plexus block with ultrasoundguidance in ESRD patients for AVF creation gives much better results than 30 ml of lidocaine 1.5% or a mixture of bupivacaine 0.5% with lidocaine 2% as regards to onset of anesthesia, postoperative analgesia and patientsatisfaction.

【 授权许可】

CC BY-NC