A Comparative Efficacy of Addition of Fentanyl v/s Neostigmine toIsobaric 0.25% Bupivacaine in USG Guided Supraclavicular BrachialPlexus Block in Upper Limb Surgeries

This study is  designed to  

1. To find out the comparative efficacy of bupivacaine with fentanyl vs bupivacaine with neostigmine for onset, duration of sensory and motor block with duration of analgesia.
2. To observe side effects of drugs among the different groups.

Fentanyl  has been used for regional nerve plexus blocks to improve the block duration and quality. The peripheral administration of opioids provides effective and long lasting analgesia without central side effects.Studies have shown better block duration and success rate of brachial plexus block on addition of fentanyl. Whereas neostigmine decreases the breakdown of acetylcholine by its inhibitory action on acetylcholinesterase, preclinical data suggests peripheral anti-nociceptive effects of acetylcholine due to its accumulation, resulting prolongation of nerve block with hemodynamic stability.

We hypothesized that peripheral nerve block with isobaric 0.25% bupivacaine and Fentanyl would be comparable to isobaric 0.25% bupivacaine and Neostigmine for the efficacy of anesthesia and analgesia, and in addition would provide a better postoperative recovery profile and readiness for discharge.