BACKGROUND AND OBJECTIVES: Over the past 10 years, several studies have suggested that the addition of certain opiates to the local anesthetic used for @entity616 may provide effective, long-lasting @entity86 . One of these studies indicated that the agonist-antagonist, @entity4783 , added to @entity1341 provided a longer period of @entity86 than the traditional opiates, but in this study, it is impossible to determine the relative contributions of the local anesthetic and the opiate to the @entity86 because of the extremely long duration of the anesthesia provided by the local anesthetic, @entity1341 . By repeating the study using a local anesthetic of a shorter duration, the present study delineates more clearly the contribution of the @entity4783 to @entity86 when added to a shorter-acting local anesthetic. METHODS: Forty, healthy, consenting adult @entity1 scheduled for upper extremity surgery were enrolled in the study. Premedication was provided by intravenous @entity1363 2 mg/70 kg and anesthesia by a subclavian perivascular brachial @entity616 . The @entity1 were assigned randomly to 1 of 2 equal groups based on the agents used for the blocks. The @entity1 in group I received 40 mL of a local anesthetic alone, while those in group II received the same local anesthetic plus @entity4783 0.3 mg. The study was kept double-blind by having 1 anesthesiologist prepare the solutions, a second anesthesiologist perform the blocks, and a third anesthesiologist monitor the anesthesia and @entity1337 thereafter, up to and including the time of the first request for an analgesic medication. The data were reported as means (+/- SEM), and differences between groups were determined using repeated measures of analysis of variance (ANOVA) and chi(2), followed by the Fisher exact test for post hoc comparison. A P value of less than.05 was considered to be statistically significant. RESULTS: The mean duration of @entity282 relief following the injection of the local anesthetic alone was 5.3 (+/- 0.15) hours as compared with 17.4 (+/- 1.26) hours when @entity4783 was added, a difference that was statistically (and clinically) significant (P <.0001). CONCLUSIONS: The addition of @entity4783 to the local anesthetic used for brachial @entity616 in the present study provided a 3-fold increase in the duration of @entity86 , with complete @entity1337 persisting 30 hours beyond the duration provided by the local anesthetic alone in 75% of the @entity1 . This practice can be of particular benefit to @entity1 undergoing ambulatory upper extremity surgery by providing prolonged @entity1337 after discharge from the hospital.

@entity4783 added to the local anesthetic for brachial XXXX to provide @entity86 in outpatients.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity1337 :: ('MESH:D000699', 'Disease') :: ['analgesia'] @entity4783 :: ('MESH:D002047', 'Chemical') :: ['buprenorphine'] @entity1341 :: ('MESH:D002045', 'Chemical') :: ['bupivacaine'] @entity86 :: ('MESH:D019106', 'Disease') :: ['postoperative analgesia'] @entity282 :: ('MESH:D010149', 'Disease') :: ['postoperative pain'] @entity1363 :: ('MESH:D008874', 'Chemical') :: ['midazolam'] @entity616 :: ('MESH:D006327', 'Disease') :: ['plexus block', 'brachial block']
@entity616 :: (MESH:D006327,Disease) :: ['plexus block']
