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      A Randomized Controlled Trial: Comparison of 4% Articaine versus 0.5% Bupivacaine for Ambulatory Orthopedic Surgery under Supraclavicular Block

      research-article
      1 , , 2
      Anesthesiology Research and Practice
      Hindawi

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          Abstract

          Background

          Articaine has been used in many dental and ophthalmic outpatient procedures. In the era of ultrasound-guided regional techniques, we searched for short and potent local anesthetic for patients undergoing ambulatory upper limb procedures. However, studies about articaine efficacy in brachial plexus block are limited. In this study, we compared its safety and efficacy against bupivacaine as a commonly used anesthetic agent for ultrasound-guided supraclavicular brachial plexus block.

          Methods

          This randomized prospective study was performed at Ain Shams University Hospital from January to March 2020. A total of 117 patients aged 20 to 60 years, with the American Society of Anesthesiologists physical status I and II, were enrolled in the study. Patients were randomly allocated into two groups: in group A, patients received 30 ml articaine 2%, and in group B, patients received 30 ml of bupivacaine 0.5%. We measured motor and sensory block duration as a primary outcome. Other secondary outcomes such as onset of block, duration of analgesia, patient satisfaction, and time to home discharge readiness were also measured.

          Results

          We analyzed data collected from 97 patients. The motor block duration was significantly shorter in group A (165.73 ± 20.33 min) than in group B (220.27 ± 37.73 min). The onset of motor block was faster in group A (8.73 ± 4.33 min), and the postoperative VAS score was lower in group B. Patients in group A achieved an earlier home discharge of 289.67 ± 2.73 min.

          Conclusion

          Earlier resolution of articaine block makes it more favorable than bupivacaine for ambulatory surgery. This trial is registered with (NCT04189198).

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          Most cited references28

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          • Article: not found

          Evidence basis for using perineural dexmedetomidine to enhance the quality of brachial plexus nerve blocks: a systematic review and meta-analysis of randomized controlled trials.

          Dexmedetomidine has been proposed as a perineural local anaesthetic (LA) adjunct to prolong peripheral nerve block duration; however, results from our previous meta-analysis in the setting of brachial plexus block (BPB) did not support its use. Many additional randomized trials have since been published. We thus conducted an updated meta-analysis.
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            • Abstract: found
            • Article: not found

            Essentials of local anesthetic pharmacology.

            It is impossible to provide effective dental care without the use of local anesthetics. This drug class has an impressive history of safety and efficacy, but all local anesthetics have the potential to produce significant toxicity if used carelessly. The purpose of this review is to update the practitioner on issues regarding the basic pharmacology and clinical use of local anesthetic formulations.
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              • Record: found
              • Abstract: found
              • Article: not found
              Is Open Access

              Guidelines for day‐case surgery 2019

              Guidelines are presented for the organisational and clinical management of anaesthesia for day-case surgery in adults and children. The advice presented is based on previously published recommendations, clinical studies and expert opinion.
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                Author and article information

                Contributors
                Journal
                Anesthesiol Res Pract
                ARP
                Anesthesiology Research and Practice
                Hindawi
                1687-6962
                1687-6970
                2020
                24 September 2020
                : 2020
                : 2194873
                Affiliations
                1Department of Anesthesia, Faculty of Medicine, Ain Shams University, Cairo, Egypt
                2Ain Shams University, Chairman of Anesthesia Department, Cairo, Egypt
                Author notes

                Academic Editor: Basavana B. Goudra

                Author information
                https://orcid.org/0000-0003-0997-8147
                Article
                10.1155/2020/2194873
                7532365
                9edae66d-7da1-4011-9e25-404ca6abf024
                Copyright © 2020 Simon H. Armanious and Gamal A. Abdelhameed.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 24 March 2020
                : 2 August 2020
                : 4 September 2020
                Categories
                Research Article

                Anesthesiology & Pain management
                Anesthesiology & Pain management

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