Ultra-sound guided supraclavicular brachial plexus block: The value of adjuvants: Review article

Abstract

Background: Upper limb surgeries are frequently performed using peripheral nerve blocks, like ultra-sound guided supraclavicular brachial plexus block, which provides safe and effective anaesthesia. Search for safe and effective adjuvants to regional nerve blocks continues, with medication that increases the duration of analgesia although it has fewer side effects. Using of drugs as dexmedetomidine, opioids, ketamine, clonidine, midazolam, epinephrine, neostigmine, magnesium sulphate and dexamethasone along with local anaesthetics for this aim with different degrees of success. Objectives: This review research investigated safety and efficacy of various additives, namely dexmedetomidine, ketamine, fentanyl, and dexamethasone, when added to bupivacaine in ultrasound guided supraclavicular brachial plexus block in order to evaluate onset and duration of sensory and motor block, estimate sedation score, pain scale and total analgesic consumption and to investigate side effects when added to bupivacaine. Conclusion: This research implies that there is still to research about the of effect of different adjuvants added to bupivacaine in ultra-sound guided supraclavicular brachial plexus block.