Sobhana Devi, P (2013) Comparative study of the Efficacy of Potassium Chloride and Sodium Bicarbonate as an Adjuvant to Bupivacaine in Supraclavicular Subclavian Perivascular Approach of Brachial Plexus Block. Masters thesis, Madurai Medical College, Madurai.
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Abstract
Sixty patients of ASA grade I&II of either sex undergoing upper limb surgeries were randomly allocated into two Groups BK and BS. Each group comprised of 30 patients. GROUP BK: 0.375% of Inj.Bupivacaine + Inj.Potassiumchloride 0.2mmol (4 units in a Insulin syringe=0.1ml) GROUP BS: 0.375% of Inj.Bupivacaine +Inj.Sodiumbicarbonate 0.17mmol (8 units in a insulin syringe =0.2ml) Surgery was done under Subclavian perivascular approach of Brachial plexus Block. Supraclavicular brachial plexus block is given with the patient lying supine with the head turned to opposite side after eliciting paraesthesia. The onset and duration of sensory loss and motor blockade are studied. The loss of pinprick sensation is checked in C4 toT2 skin dermatome every 1 minute till the onset of loss of sensation and every 1 hourly till the regain of sensation. The motor blockade is assessed every 1 minute by modified Bromage score and every 1 hourly till the regain of movements. The following parameters were observed: 1. Onset of sensory block, 2. Onset of motor block, 3. Duration of sensory block, 4. Duration of motor block, 5. Tourniquet tolerance, 6. Quality of block, 7. Hemodynamic stability, 8. Complications. Potassium chloride when added as an adjuvant to Bupivacaine has sensory onset of 6-8mins(7.63±0.56) and motor onset of 3-4mins (3.9±0.31). Sodiumbicarbonate when added as an adjuvant to Bupivacaine has sensory onset of 8-11 mins(9.8±0.64) and motor onset of 5-6mins(5.2±0.41).The duration of motor block is 240-270mins (245±11.4) in Group BK and 360-420 mins(417±12.1) in Group BS. The duration of sensory block is 420-480mins(476.6±13.2) in Potassium chloride BK group whereas the duration of sensory block is 600-720 mins(608±26.1) in Sodiumbicarbonate BS group. CONCLUSION: Potassium chloride when added as an adjuvant to Bupivacaine has sensory onset (Range( mean±standard deviation)) of 6-8mins(7.63±0.56) and motor onset of 3-4 mins(3.9±0.31) Sodiumbicarbonate when added as an adjuvant to Bupivacaine has sensory onset of 8-11 mins(9.8±0.64) and motor onset of 5-6mins(5.2±0.41) The duration of motor block is 240-270mins(245±11.4) in Group BK and 360-420 mins(417±12.1) in Group BS. The duration of sensory blockade is 420-480mins(476.6±13.2) in Potassium Chloride group whereas 600-720 mins(608±26.1) in Sodiumbicarbonate group. Hence it is concluded that , in brachial plexus blockade, The addition of potassium chloride as an adjuvant to bupivacaine shortens the onset time of sensory and motor blockade whereas the addition of sodiumbicarbonate prolongs the duration of sensory and motor blockade.The quality of anaesthesia is good in both the groups.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Potassium Chloride, Sodium Bicarbonate, Adjuvant, Bupivacaine, Supraclavicular Subclavian Perivascular Approach, Brachial Plexus Block. |
| Subjects: | MEDICAL > Anaesthesiology |
| Depositing User: | Subramani R |
| Date Deposited: | 08 May 2018 19:52 |
| Last Modified: | 25 Mar 2020 16:26 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/7666 |
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