|
Bone et al. (1999) (
29
)
|
Patients between 18 to 75 y of age, ASA I or II scheduled for an elective upper extremity surgery with an axillary plexus block. Exclusion criteria included the use of analgesics 24 hrs before surgery, pregnancy, history of asthma or arrhythmias, and allergy to anesthesia. |
No difference between the two groups in the onset for nerve block and the total duration of the block. Lower reported pain rating on a visual analog scale (VAS: 14.7 ± 9.9 vs. 32.4 ± 23.5; P < .05) in the neostigmine plus mepivacaine group 24 hours post-surgery and they required less additional analgesics in the first 24 hours post-surgery (P < 0.05). |
Neostigmine was an effective adjuvant anesthetic at relieving postoperative pain with axillary brachial plexus blocks. |
|
Ridenour et al. (2001) (
48
)
|
Healthy subjects not taking medications that alter pain perception. Teeth were free of caries, periodontal disease, large restorations, or trauma. |
No improvement in anesthetic success (P < 0.05) with hyaluronidase. lidocaine with hyaluronidase group had an increase in postoperative pain (P < 0.05). |
Hyaluronidase should not be added to anesthetic during an IAN block. |
|
Saatchi et al. (2015) (
49
)
|
Healthy patients over 18 with active pain in a mandibular posterior tooth. Exclusion criteria included significant medical conditions, allergies to local anesthetics, active areas of disease at the injection site, or taking medications to affect anesthetic assessment. |
Was no significant difference in anesthetic success between group using sodium bicarbonate buffered lidocaine with epinephrine vs. non-buffered lidocaine with epinephrine (P > 0.05). |
The success of an IAN block in mandibular molars with irreversible pulpitis was not improved with buffering a lidocaine with epi solution with sodium bicarbonate. |
|
Saatchi et al. (2016) (
50
)
|
Healthy patients over 18 with active moderate to severe pain in vital mandibular first molar. |
Statistically higher success rate using the sodium bicarbonate buffered lidocaine with epinephrine solution vs. non buffered lidocaine with epinephrine using a buccal infiltration (P < 0.05). |
The efficacy of an IAN block in mandibular first molars with irreversible pulpitis was improved with sodium bicarbonate buccal infiltration. |
|
Song et al. (2014) (
58
)
|
Patients 18 - 65 years of age, ASA I or II scheduled for upper extremity surgery and brachial plexus block. Exclusion criteria included BMI > 35, pregnancy, liver or kidney disorder, diabetic neuropathy, arrythmia, or α-2 adrenergic drug within 2 weeks. |
Increase in motor and sensory block duration and an increased time when first onset of pain with epinephrine and dexmedetomidine (P < 0.05). No difference in onset time to complete block as compared to mepivacaine (P < 0.05). |
Duration of block and post-op control of pain with dexmedetomidine is similar to epinephrine. |
|
Kelika et al. (2017) (
59
)
|
Patients 18 - 50 years of age, ASA I or II with routine or emergency forearm and hand surgery, surgery performed under tourniquet. Patients with cardiovascular, respiratory, CNS, liver, or kidney disease and bleeding disorders were excluded. |
Increase in sensory, and motor onset as well increased duration of sensory and motor block, and longer time until rescue analgesic needed with both groups of clonidine as compared to tramadol (P < 0.001). |
Clonidine provides a quicker onset and longer-lasting level of a brachial plexus block. |
|
Alhelail et al. (2009) (
60
)
|
Patients over 18 years of age without a hx of cardiovascular, liver, diabetes, peripheral vascular disease, or hand conditions. |
Less pain at the injection site and shorter duration of anesthetic seen in lidocaine plus epinephrine group (P < 0.05). |
Lidocaine plus epinephrine was sufficient to use for emergency room procedures. |
|
Kim et al. (2020) (
61
)
|
Patients between 19 and 76 years of age ASA I or II with unilateral upper extremity surgery. |
There was no significant difference in the perfusion index or ratio when using epinephrine as an adjuvant drug (P = 0.894 and P = 0.079, respectively). |
The PI and PI ratio were not affected with the use of epinephrine. |
|
Zhu et al. (2020) (
62
)
|
Patients aged 25 - 45, ASA I or II undergoing elective ACL repair. |
No difference in onset of motor block between groups. Decreased post op pain, longer onset for rescue analgesic, and longer duration of sensory block see in ketamine and ropivacaine group. |
Ketamine given preoperatively improved patient satisfaction and patients experienced less postoperative pain. |
|
Sunder et al. (2008) (
18
)
|
3 case reports of patients aged 28 - 45 years old with gunshot wounds with CRPS Type II. |
Dramatic and long-lasting relief of heat allodynia seen with ketamine. |
Ketamine impact on central pain pathway showed positive response on heat allodynia symptoms. |
|
Akhondzadeh et al. (2019) (
63
)
|
Patients aged 18 to 75 years of age, ASA I or II undergoing upper extremity surgery due to fracture. |
The fentanyl group showed less pain 9, 12, and 24 hours post-surgery compared to ketamine group. |
Fentanyl may be a better adjuvant for axillary blocks compared to ketamine. |
