RT - Journal TY - JOUR A1 - Metwally, Ahmed A1 - Ibrahim, Ezzeldin A1 - Mahdy, Wafiya A1 - Al Lahouny, Marwa T1 - Ultrasound-guided double-injection infraclavicular brachial plexus block: Bupivacaine alone or with added dexmedetomidine or fentanyl YR - 2018/1/1 JF - Menoufia Medical Journal JO - Menoufia Med J SP - 76 OP - 82 VO - 31 IS - 1 UL - http://www.mmj.eg.net/article.asp?issn=1110-2098;year=2018;volume=31;issue=1;spage=76;epage=82;aulast=Metwally;t=5 DO - 10.4103/mmj.mmj_586_16 N2 - Objective The aim of this study was to evaluate the effects of adding dexmedetomidine or fentanyl to bupivacaine in ultrasound-guided infraclavicular block (ICB) for upper limb surgeries. These effects include quality and duration of the analgesia and analgesic consumption. Background ICB provides anesthesia and analgesia to the upper limb. Many adjuvants have been used to improve the quality and duration of analgesia in various nerve blocks. Patients and methods A total of 120 adult patients undergoing elective forearm or hand surgeries received ICB with 27 ml of local anesthetic mixture, and were randomly allocated according to the local anesthetic mixture into three groups – group C (control group) (bupivacaine), group D (dexmedetomidine) (bupivacaine+dexmedetomidine), and group F (fentanyl) (bupivacaine+fentanyl). The three groups were compared for the time of onset of sensory and motor blocks, postoperative analgesia, hemodynamic changes, and complications. Results The onset of sensory and motor blockade was significantly more rapid in group D than in groups C and F. The duration of sensory and motor blockade was significantly longer in group D than in the groups C and F. The duration of analgesia was significantly longer in group D than in groups C and F. Heart rate levels were also low in D group compared with groups C and F during the period of anesthesia. Conclusion We conclude that the addition of dexmedetomidine to a local anesthetic mixture in ultrasound-guided infraclavicular brachial plexus block hastens the onset and prolongs the duration of sensory and motor blocks, as well as the duration of postoperative analgesia, compared with the addition of fentanyl or bupivacaine administration alone. ER -