الفهرس 
Introduction
Anatomy of the brachial plexusOnly 14 pages are availabe for public view
 |  | from | 7 |  |  |
| | | from | 7 | | |
Abstract
Aim of work: This study was designed to evaluate the effect of local anesthetic combinations with or without adjuvant (fentanyl or tramadol) aiming for achieving optimal analgesia and decreasing the totally required dose of bupivacaine and its toxicity after supraclavicular brachial plexus block. Methods: This study was carried out on 45 patients of either sex with age ranging from 18 - 55 years submitted at Emergency Mansoura University Hospital for elective upper limb orthopedic surgery. Patients were classified into 3 groups, 15 patients each: Group I: Received bupivacaine 0.5% with lidocaine 1%. Group II: Received bupivacaine 0.25% with lidocaine 1% with 100g fentanyl. Group III: Received bupivacaine 0.25% with lidocaine 1% with 100mg tramadol. Onset of the block (motor & sensory), duration of motor block, duration of analgesia and routinely monitoring parameters were recorded Results: No significant difference between the three studied groups as regarding age, sex, mean operative time, onset of motor and sensory block. There were a significant prolongation of the duration of motor block and analgesia in group I in comparison to the other groups and in group II in comparison with the group III. Conclusion: We conclude that the use of bupivacaine, lidocaine combination regimen for BPB allowed a reduction of the total required dose of bupivacaine and also a more reduction in bupivacaine dosage was achieved when fentanyl or tramadol was added to such regimen.