| Title | Sufentanil does not prolong the duration of analgesia in a mepivacaine brachial plexus block: a dose response study. | | Author(s) | Bouaziz H, Kinirons BP, Macalou D, Heck M, Dap F, Benhamou D, Laxenaire MC | | Institution | Département d'Anesthésie-Réanimation, CHU Hôpital Central, Nancy, France. h.bouaziz@chu-nancy.fr | | Source | Anesth Analg 2000 Feb; 90(2):383-7. | | MeSH | Adult
Aged
Aged, 80 and over
Analgesia
Analgesics, Opioid
Anesthetics, Local
Brachial Plexus
Carpal Tunnel Syndrome
Dose-Response Relationship, Drug
Double-Blind Method
Female
Humans
Male
Mepivacaine
Middle Aged
Motor Neurons
Nerve Block
Neurons, Afferent
Prospective Studies
Sufentanil
Time Factors
| | Abstract | To date, results of studies evaluating the efficacy of opioids and local anesthetic combinations in the brachial plexus are inconclusive. We examined whether increasing sufentanil in doses of 5, 10, and 20 microg decreased onset time or increased duration of an axillary brachial plexus block. Ninety-two patients scheduled for carpal tunnel release under axillary brachial plexus block were enrolled in the study. Patients were randomized to receive axillary plexus block with 40 mL 1.5% mepivacaine and saline (Group 1), sufentanil 5 microg (Group 2), 10 microg (Group 3), or 20 microg (Group 4). Onset and duration of sensory and motor block were measured. Opioid-related side effects were recorded. The addition of sufentanil did not improve speed of onset or increase the duration of sensory or motor block. Paradoxically, duration of sensory and motor block was longest in the control group: sensory, 241 min (188-284) and motor, 234 min (128-305), and decreased with increasing doses of sufentanil in Group 4: sensory, 216 min (115-315) and motor, 172 min (115-260) (P < 0.05). Side effects occurred in 55% of patients belonging to Groups 2 and 4, and in 60% of the patients in Group 3. In contrast, only 10% of the patients reported side effects in the control group. We conclude that sufentanil added to mepivacaine does not increase the onset or prolong the duration of an axillary plexus block. Furthermore, the addition of sufentanil was associated with a frequent incidence of side effects.
IMPLICATIONS: This study demonstrates that the addition of sufentanil in a dose-dependent manner to 1.5% mepivacaine in the axillary plexus does not improve onset or duration of blockade, and that this admixture is associated with an increased incidence of side effects. | | Language | eng | | Pub Type(s) | Clinical Trial
Journal Article
Randomized Controlled Trial
| | PubMed ID | 10648326 |
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