الفهرس 
Introduction
Aim of StudyOnly 14 pages are availabe for public view
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Abstract
The axillary brachial plexus block is a popular nerve block for forearm, wrist and hand surgery. It can be used to provide regional anesthesia or as an analgesic technique to be used in combination with general anesthesia. It has the advantage of being performed away from the pleura and neuraxial structures. In 2012, the American Society of Anesthesiologists (ASA) released an update to its Practice Guidelines for Acute Pain Management in the Perioperative Setting. In this report, the ASA strongly recommends use of a multimodal approach to pain management whenever possible. Opioid antinociceptive properties is well documented, so consequently their addition to a LA solution as a means of extending the duration of pain relief and as a way of decreasing the dosage of LA required for pain treatment, is apparent. Recent reports have suggested that morphine injected perineurally in patients with chronic pain may also have a clinically significant effect and that its duration of action may be longer than that of systemically administered morphine.
The primary end point of this prospective controlled double-blind clinical trial is evaluating effect of morphine on onset, duration and quality of analgesia when added to local anesthetics in axillary brachial plexus block.
The secondary end point is detecting any complications occurred with this technique.
The main finding of this study was that there was statistically significant difference in duration of analgesia which was longer duration in morphine group 23.3 ± 8 than in placebo group 12.8 ± 4.1 with p-value = 0.001. Also, total analgesic consumption was significantly lower in morphine group 10.3 ± 17.7 than placebo group 30 ± 12.2 with p-value = 0.001. Also, there were no complications occurred with morphine administration.
conclusion
We conclude that morphine provide better postoperative analgesia when injected with local anesthetics in ultrasound guided axillary brachial plexus block without an increase in frequency of complications.