Comparison of onset, duration and quality of supraclavicular block using 0.5% bupivacaine with magnesium sulphate , ketamine and neostigmine in forearm orthopedic surgery

Comparison of onset, duration and quality of supraclavicular block using 0.5% bupivacaine with magnesium sulphate , ketamine and neostigmine in forearm orthopedic surgery

The study will be double blind and clinical trial. 90 patients will be randomly divided into 3 groups. The groups will be parallel. The trial phase will be 3.

Candidates forearm orthopedic surgery in Valiasr Hospital in Arak are divided into 3 groups by simple randomization with envelopes. The study is double-blind in which outcome evaluator and data analyst and participant are kept blind.

Inclusion criteria:20 -70 years ,candidate for upper limb orthopedic surgery ,no more than one fracture in the body or surgery ,no blood coagulation diseases and disorders in PTT, PT and INR ,body mass index less than 35 ,lack of psychological problems ,no pregnant ,absence of neurological disorders in the hand ,no allergies to drugs used ,absence of chronic pain syndrome Exclusion criteria:Lack of patient cooperation to perform the block ,block failure ,surgery time less than 50 and more than 150 minutes ,need for more sedation than stated in the plan

Intervention group 1: 25 milliliter of 0.5% bupivacaine with 100 milligram of magnesium sulfate (1 millilite of 10% solution) is prescribed. (Bupivacaine by Strazenka UK-Magnesium Sulfate by Shahid Ghazi Co in Tabriz) Intervention group: 25millilite of bupivacaine 0.5% with 2 milligram in kilogram of ketamine is prescribed. (Ketamine made by Rotex Medica - Germany) Intervention group 3:25 millilite of 0.5% bupivacaine with 500 micrograms of neostigmine is prescribed. (Neostigmine ampoule made by Caspian Tamin Co - Rasht)

Pain, narcotics consumption, sensory block, motor block

Simple individual randomization with random allocation with envelopes in 3 groups A and B and C. In this method, we selected a number of cards or letters as an intervention group and the same ‎number of cards for the control group, then the cards were merged. One card was taken out and its ‎allocation was registered and the card was returned to the other cards after leaving. Then the cards ‎are merged again and we remove another card. This process continues to reach a random sequence ‎according to sample size.

Outcome assessor and data analyzer and participant are blind (double blind). Outcome assessor and data analyzer and participant don't aware from grouping.