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Effect of Ultra-low Dose Naloxone During Supraclavicular Brachial Plexus Block on Post-operative Opioi

Not Applicable
Completed
Conditions
Upper Extremity Trauma
Interventions
Registration Number
NCT03372486
Lead Sponsor
Mansoura University
Brief Summary

Effective post-operative pain control can reduce patient morbidity and affect the patient outcome. Brachial plexus block is one of them, a popular and widely employed regional nerve block technique for perioperative anesthesia and analgesia for surgery of the upper extremity.

Different drugs have been used as adjuvants with local anesthetics in brachial plexus block to achieve quick, dense and prolonged block like Morphine, Pethidine, Clonidine, Dexmedetomidine.

Naloxone is opioid antagonists which could selectively block the excitatory effects of opioids. it release endorphins and also displace endorphins from receptor site .it also reduce the opioid induced side effects, such as vomiting, nausea, pruritus, and respiratory depression.

Detailed Description

The aim of this study is to evaluate the effect of ultra-low dose of naloxone when added to bupivacaine %.05 in supraclavicular brachial plexus block in orthopedic upper limb surgery and if it enhances the anti-nociceptive effect of post-operative opioid

Effect of naloxone on anti-nociceptive criteria of post -operative opioid will be estimated by detecting the interval between each analgesic dose of post-operative opioid.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
64
Inclusion Criteria
  • American Society of Anesthesiology (ASA) physical state class Ι and II
  • Elective upper limb orthopedic surgery (hand, forearm and elbow)
  • Duration of surgery ≤180 min
  • BMI ≤30 kg/m2
Exclusion Criteria
  • History of allergy to the drug of the study.
  • Coagulation disorders
  • Infection at the puncture site.
  • Pregnancy
  • Opioid abuse.
  • Abuse of tranquilizers

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Bupivacaine plus naloxoneBupivacaine plus naloxonePatients will receive brachial plexus block using bupivacaine plus naloxone.
BupivacaineBupivacainePatients will receive brachial plexus block using bupivacaine.
Primary Outcome Measures
NameTimeMethod
Effect of ultra-low dose naloxone on the post operative opioidfor 48 hours after surgery

by estimate the analgesic requirements of opioids and the interval between each opioid dose in 48 hour post operative

Secondary Outcome Measures
NameTimeMethod
Duration of sensory blockFor 48 hours after surgery

will be defined as the time interval between the complete sensory block (complete absence of pinprick response) and first experience with postoperative pain

Duration of motor blockFor 48 hours after surgery

defined as the time interval between complete paralysis (Lovett rating scale = 0) and complete recovery (Lovett rating scale = 6)

Onset time of sensory blockFor 48 hours after surgery

defined as the time between the end of the last injection and complete absence of pinprick response in all nerve distribution

Onset time of motor blockFor 48 hours after surgery

defined as the time between the end of the last injection and complete paralysis (Lovett rating scale = 0) in all nerve distributions

Severity of post-operative painFor 48 hours after surgery

will be measured by visual analogue scale (VAS) where 0 was equal to no pain and 10 indicated the worst possible pain

1st time of analgesic requestFor 48 hours after surgery

First need for rescue opioid after surgery

Trial Locations

Locations (1)

Mansoura University, Central Hospital, emergency Unit

🇪🇬

Mansourah, Dakahlia, Egypt

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