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Brachial plexus anesthesia with verapamil and/or morphine
1Department of Anesthesiology, Baystate Medical Center and the Tufts University School of Medicine, Springfield, MA 01199, USA. scott.reuben@bhs.org
Anesthesia and Analgesia
|July 27, 2000
Summary
Calcium channel blockers like verapamil can extend the duration of sensory anesthesia when added to brachial plexus blocks. However, combining verapamil with morphine in these blocks did not improve pain relief or reduce opioid use post-surgery.
Area of Science:
- Anesthesiology
- Pharmacology
- Pain Management
Background:
- Calcium channel blockers (CCBs) are known to enhance the analgesic effects of local anesthetics and opioids.
- Verapamil, a CCB, has shown potential in modulating pain pathways.
Purpose of the Study:
- To investigate the analgesic effects of combining morphine and verapamil with lidocaine in brachial plexus anesthesia for upper extremity orthopedic surgery.
- To determine if verapamil addition impacts the duration of anesthesia and postoperative pain management.
Main Methods:
- A randomized study involving 75 patients undergoing upper extremity orthopedic surgery.
- Patients received brachial plexus anesthesia with lidocaine and epinephrine, plus various combinations of intravenous/intrabrachial verapamil and morphine.
- Pain scores and analgesic use (acetaminophen/oxycodone) were recorded over 24 hours.
Main Results:
- Brachial plexus blocks with morphine significantly increased analgesic duration and decreased 24-hour opioid consumption (Groups 3 and 5).
- Addition of verapamil to the brachial plexus block with lidocaine significantly prolonged the duration of sensory anesthesia (Groups 4 and 5).
- Verapamil did not enhance the analgesic duration or reduce overall opioid use when combined with morphine in the block.
Conclusions:
- Verapamil, when added to lidocaine brachial plexus blocks, can extend sensory anesthesia duration.
- Combining verapamil with morphine in brachial plexus blocks does not improve 24-hour pain relief or reduce analgesic use.
- The findings suggest a potential role for verapamil in prolonging nerve block duration, but not in enhancing opioid-sparing analgesia in this context.
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