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Hyaluronidase is a biologic enzyme that acts as a spreading factor by depolymerizing hyaluronic acid, a key component of the extracellular matrix in connective tissues. In clinical research conducted by Sohag University, hyaluronidase is utilized as an adjuvant to the local anesthetic bupivacaine in ultrasound-guided supraclavicular brachial plexus blocks. The primary objective of this combination is to enhance the onset of sensory and motor nerve blocks for patients undergoing upper limb surgery, thereby improving postoperative pain management. By breaking down the interstitial barrier, hyaluronidase facilitates the diffusion of bupivacaine toward the target nerves. The Sohag University study specifically evaluated a dose of 800 IU of hyaluronidase added to 0.375% bupivacaine, demonstrating a significantly faster onset of anesthesia without altering the overall duration of the block.
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