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Study aim
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Comparison the effect of ketamine-lidocaine and fentanyl-lidocain on postoperative analgesia in axillary block with Ultrasound Guide in upper limb fractures
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Design
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The study is design as a randomised, controlled, parallel group trial with double blinded outcome assessment. Randomisation was centralised based on randomized block randomization method.
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Settings and conduct
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Sixty patients candidate of orthopedic surgery of forearm and hand fractures in age group 18 to 75 years are randomly divided into intervention (1) and (2) group. Using an ultrasound device, the neural network is identified and a sterile needle with ultrasound-guided is imported in the axillary space, then medication is injected around the neural network.
Pinprick test and three-point scale test are used to evaluate the sensory and motor block of the median, ulnar, radial and musculocutaneous nerves.
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Participants/Inclusion and exclusion criteria
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Inclusion criteria are patients under orthopedic surgery of forearm and hand fractures in age group 18 to 75 years and ASA Class I , II; The exclusion criteria are allergic reaction to drugs used in the study, patients with anemia or bleeding disorders, infection of block location, nerve damage of the limb caused by trauma, neuropathy and addiction to narcotics.
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Intervention groups
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In the Intervention group (1), patients are received 4mg/kg lidocaine 1% and 50mcg fentanyl during axillary block and in the intervention group (2), patients are received 4mg/kg lidocaine 1% and 30 mg ketamine during axillary block.
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Main outcome variables
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The time of completion of the sensory and motor block are recorded every 15 minutes after the patient enters the recovery room. Postoperative pain in 0, 1, 2, 4, 8, 16 and 24 hours after surgery, the first time of request for narcotic and the amount of narcotic consumption after surgery are measured.