Hemodynamic Effects of Alkalinized Fentanyl–Bupivacaine and Fentanyl Bupivacaine without Alkalinization in Supraclavicular Brachial Plexus Block

Background with Objective: Haemodynamic changes are very crucial issues during regional anaesthesia. The aim of the present study was to assess the hemodynamic changes of alkalinized Fentanyl Bupivacaine and Fentanyl Bupivacaine without alkalinization in supraclavicular brachial plexus block. Methodology: This single centered double blind randomized controlled trial was carried out in the Department of Anaesthesiology and Intensive Care Medicine of Chittagong Medical College in collaboration with Department of Orthopaedics surgery of Chittagong Medical College Hospital, Chattogram, Bangladesh From August 2019 to September 2020. A total of 100 patients undergoing upper limb orthopaedic surgery under Supraclavicular Brachial Plexus Block will be randomized in to two groups according to the anaesthetic medication used: Group A: 30ml solution of 0.25% bupivacaine with 75(µg) fentanyl, Group B: alkalinized 30 ml solution of 0.25% bupivacaine with 75µg fentanyl. Results: The mean (±SD) time to achieve complete block was 21.58±1.2 minutes in group A and 16.38±0.8 minutes in group B. The comparison showed very highly significant difference in independent sample t-test between two groups. Per-operative mean systolic blood pressure, diastolic blood pressure, mean pulse rate, mean respiratory rate, mean SPO2% changes just after block and after 30 minutes showed no significant mean difference between two groups. The mean (±SD) duration of surgery was 99.42±5.7 minutes in group A and 102.34±4.9 minutes in group B. The comparison showed significant (p=0.008) difference in independent sample t-test between two groups. Conclusion: Alkalinized fentanyl–bupivacaine can be considered a safe and effective alternative to the non-alkalinized combination without compromising peri-operative hemodynamic parameters. Medicine Today 2026, Vol.38 (2): 196-199