The Influence of Warm Bupivacaine on Supraclavicular Plexus Block Characteristics

Mansoura University90 enrolled

Overview

Despite PH adjustment of local anesthetic solution improves the quality of the block in all respects with special advantage of early onset of sensory and motor block, adequate level of analgesia, and prolongation of duration of block, the effect of warmed bupivacaine should have the same effect which have not been evaluated on supraclavicular plexus block for upper limb surgery. The warmed bupivacaine used in supraclavicular plexus block may reduce sensory and motor block onset and prolong the duration of analgesia when compared to bupivacaine at operating room temperature.

The aim of this study is to compare the effect of warm bupivacaine 0.5% at 37◦C versus bupivacaine 0.5% at operating room temperature at 23◦C on ultrasound-guided supraclavicular plexus block characteristics as regard sensory block onset time, motor block onset time, duration of sensory and motor block , effective duration of analgesia, total analgesics requirement, complications and side effects.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

SUPPORTIVE_CARE

Masking

DOUBLE

Enrollment

Conditions

Surgery to the Distal One Third of the Upper Limb

Interventions

Warm bupivacaine at (37°c)DRUG

Bupivacaine 0.5%, 30 mL, warmed to 37◦C for 20 minutes. The empty syringes and needles, in their packaging, will be held at the same temperature before initiating the block.

Bupivacaine at operating room temperature (23°c)DRUG

Bupivacaine 0.5%, 30 ml held in crash shelf of the operating room temperature at 23◦C. The empty syringes and needles will be held in the same temperature before use.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 45 Years

Medical Language ↔ Plain English

Inclusion Criteria: * American Society of Anesthesiologists physical class I or II Exclusion Criteria: * Patient refusal. * Pregnancy * Neuromuscular diseases (as myopathies, myasthenia gravies…) * Hematological diseases * Bleeding disorders * Coagulation abnormality. * Psychiatric diseases. * Local skin infection * Sepsis at site of the block. * Known intolerance to the study drugs. * Body Mass Index \> 40 Kg/m2. * Bilateral upper limb injury to be performed at the same procedure.

Locations (1)

Mansoura University, Faculty of Medicine

Al Mansurah, DK, Egypt

Outcomes

Primary Outcomes

Time to onset of sensory block

defined as the time interval between the end of local anesthetic injection and the loss of sensation to pinprick (sensory score = 1)

Time frame: for 30 min following injection

Secondary Outcomes

Time to onset of motor block

defined as time interval between the end of local anesthetic injection and (motor score = 1) in the distributions of all 4 peripheral nerves.

Time frame: For 3 hours after the injection of local anesthetic

Heart rate

Time frame: For 3 hours after the injection of local anesthetic

Blood pressure

Time frame: For 3 hours after the injection of local anesthetic

oxygen saturation in the peripheral blood

Time frame: For 3 hours after the injection of local anesthetic

Duration of sensory block

defined as the interval between end of injection and complete end of sensory block (score=2)

Time frame: For 24 hours after the injection of local anesthetic

Duration of motor block

defined as the interval between end of injection and complete recovery of normal motor function (score=0), respectively.

Time frame: For 24 hours after the injection of local anesthetic

The severity of postoperative pain

will be measured and recorded by using a 100-cm visual analog scale (VAS) for pain, where 0 is equal to no pain and 100 indicates the worst possible pain.

Data from ClinicalTrials.gov

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