The Effect of Hyaluronidase as an Adjuvant to Local Anaesthetics in Peripheral Nerve Stimulator-guided Supraclavicular Brachial Plexus Block: A Randomised Controlled Study
Introduction: For upper limb procedures using the supraclavicular approach to brachial plexus block, various adjuncts to Local Anaesthetics (LA) have been employed to improve the quality and duration of anaesthesia and postoperative analgesia without leading to any adverse sideeffects or prolong...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2024-12-01
|
| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://www.jcdr.net/articles/PDF/20320/75281_CE[Ra1]_QC(AnK)_F(IS)_PF1(VD_SHU)_redo_PFA(SHU)_PB(IS)_PN(IS).pdf |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| Summary: | Introduction: For upper limb procedures using the
supraclavicular approach to brachial plexus block, various
adjuncts to Local Anaesthetics (LA) have been employed
to improve the quality and duration of anaesthesia and
postoperative analgesia without leading to any adverse sideeffects or prolonging the period of motor block. Hyaluronidase is
an enzyme used with other drugs to accelerate their dispersion
and distribution. It catalyses the hydrolysis of a component
of the extracellular matrix, hyaluronan, thereby lowering its
viscosity and improving tissue permeability.
Aim: To evaluate the sensory and motor blockade resulting from
the addition of hyaluronidase as an adjuvant to LA in Peripheral
Nerve Stimulator (PNS)-guided Supraclavicular Brachial Plexus
Block (SBPB).
Materials and Methods: This prospective, comparative,
double-blinded, randomised controlled study was conducted in
a Department of Anaesthesiology S.B.K Shah Medical Institute
and Research Centre, Vadodara, Gujarat, India at a tertiary care
hospital on 72 patients undergoing elective upper limb surgeries
under PNS-guided SBPB over 18 months from November 2022
to August 2024. Group B (n=36) received inj. bupivacaine (0.5%)
13 mL, inj. lignocaine with adrenaline (2%) (1:200,000) 13 mL,
and inj. normal saline (0.9%) 4 mL, for a total of 30 mL, and Group
H (n=36) received inj. bupivacaine (0.5%) 10 mL, inj. lignocaine
with adrenaline (2%) (1:200,000) 10 mL, inj. hyaluronidase (900
IU) 6 mL, and inj. normal saline (0.9%) 4 mL, for a total of 30
mL. Sensory and motor blockade and rescue analgesia were
recorded at 0, 1, 3, 5, 7, and 10 hours. Categorical variables
were analysed using the Chi-square test. To analyse continuous
variables, the student’s t-test was used. The p-value of less
than 0.05 was deemed statistically significant.
Results: The onset time of sensory and motor block was
earlier with Group H (2.36±0.25 minutes and 4.2±0.29
minutes) than with Group B (4.54±0.25 minutes and 6.51±0.29
minutes), respectively (p<0.05). The sensory and motor block
lasted longer in Group B (278.8±7 minutes and 266.8±6.78
minutes) than in Group H (263.2±7 minutes and 246.3±6.78
minutes) respectively, p<0.05. The duration of analgesia was
longer with Group B (240.8±7.84 minutes) compared to Group
H (220±7.84 minutes) p<0.05. No major adverse effects were
observed.
Conclusion: Addition of hyaluronidase to a lower volume of LA
results in rapid onset of the block with minimal side-effects. |
|---|---|
| ISSN: | 2249-782X 0973-709X |