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Abstract
The infraclavicular brachial plexus block is similar to other methods of brachial plexus block, is designed to deposit local anesthetic agent high in the brachial plexus , achieving anesthesia of the hand, wrist, forearm and even the shoulder.
Infraclavicular brachial plexus block has recently become a technique of increasing interest due to decrease in the complications resulting from it.
Unlike the other methods of the brachial plexus block, the infraclavicular block carries no risk of accidental intrathecal, epidural, intra vertebral artery injection, paralysis of the hemi diaphragm or pneumothorax.
There are several technical modifications of infraclavicular brachial plexus block, most of the modern techniques use the coracoid process as the main landmark. In this study, the used technique was the infraclavicular brachial plexus block (coracoid approach).
Ropivacaine is the newest local anesthetic recently used in the mid ninety suited for peripheral nerve blockade. It is characterized by is which is a long - acting. Clinically, it offers the advantage of a dense sensory / motor block that is fast in onset and extended in duration and less cardiotoxic and less side effects than bupivacaine.
The ideal local anesthetic must has rapid onset, extended duration for analgesia and less effect on motor power and the ropivacaine has these properties.
Lignocaine is an amide local anesthetic has a rapid onset of action but its duration is short reaching to 1.5 in addition its usage as an antiarrhythmic drug Adenosine acting on specific receptors stimulation produces analgesia by both peripheral and central mechanisms. It is used intrathecal injection for treatment chronic neuropathic pain.
This study aimed to comparing the efficacy of postoperative pain relief to unilateral surgery of the upper limb involving elbow ,forearm, wrist and hand through infraclavicular brachial plexus block (ICB) in a continuous infusion by using ropivacaine or lignocaine alone or combined with adenosine.