Additive Effect of Sulfantil to Lidocain and Bupivacain for Supraclavicular Brachial Plexus Block

Purpose: We evaluated the effect of adding Sufentanil to the mixture of Lidocaine and Bupivacaine used for supraclavicular brachial plexus block in reducing postoperative pain. Method: This double-blind clinical intervention trial was conducted in 2007. Patients scheduled to undergo upper limb orthopedic surgeries under supraclavicular brachial plexus block were recruited. Participants of one arm were given the mixture of Sufentanil, lidocaine, and bupivacaine (Group S) while those of the other arm were given the mixture of later two drugs (Group C). Postoperative pain assessment was done every hour postoperatively till the first administration of systemic analgesic. We used a subjective pain score and duration of lack of muscle movement as a parameter to judge outcomes. The mean and standard deviation were compared of both arms. Result: We included 50 patients in both arms. The mean duration of the motor blockade in group S and C were 342.8 (± 145.4) and 171.1 (±50.2) minutes respectively. The additive effect of Sufentanil in motor blockage was 171.7 (95% CI 128.5–214.9) (p = 0.1×10-6). The mean duration of analgesia in group S and C were 892 (±34.7) and 350 (±72.1) minutes respectively. The additive effect of Sufentanil in analgesia was 542 (95% CI 524–559) (p = 0.1×10-6). In group S, one patient developed cardiac pain following pneumothorax and two had temporary Horner syndrome. Conclusion: Analgesia in the postoperative period can be enhanced with the addition of Sufentanil (an opioid) to local anesthetics in supraclavicular brachial plexus block.