Comparison of the Efficacy of 0.5 Percent Levobupivacaine with a Combination of 0.5 Percent Levobupivacaine and Hyaluronidase, in Ultrasound Guided Axillary Brachial Plexus Block for Forearm and Hand Surgeries.
Journal Title: International Journal of Medical Science and Innovative Research (IJMSIR) - Year 2019, Vol 4, Issue 6
Abstract
Introduction: Axillary block is a regional anesthesia for surgeries at and below the elbow. Complications associated with peripheral blocks using blind approaches are addressed with advent of ultrasound guidance. Hyaluronidase drug works as a spreading factor. Combination of ultrasound guidance and hyaluronidase in addition to local anesthetics in peripheral blocks will increase efficacy and reduce complications. Objective:To compare the efficacy of 0.5% Levobupivacaine with a combination of 0.5% Levobupivacaine and hyaluronidase in USG guided axillary brachial plexus block for forearm and hand surgeries with respect to: Onset of sensory and motor block, duration of sensory block and time to rescue analgesia. Methods: A prospective study was conducted on sixty adult patients aged 18-60 years belonging to ASA PS 1 and 2 scheduled to undergo elective upper limb below elbow orthopedic procedures. Thirty patients each in Group A and B received 20 ml of 0.5% Levobupivacaine along with 300 units of hyaluronidase and 20 ml of 0.5% levobupicavaine only respectively. Sensory and motor block onset, sensory block duration and rescue analgesia were compared. Data were analyzed using SPSS 16.0V software. P<0.05 was considered statistically significant. Results: The sensory and motor block onset was shorter in the Group A - 10.10 minutes vs Group B 13.33 minutes; and Group A 11.73 minutes vs 14.23 minutes; respectively. Duration of sensory block was shorter in Group A compared to Group B (468 minutes vs 648 minutes) .Time to rescue analgesia was also significantly reduced in Group A-594 minutes vs Group B- 732 minutes. Conclusion: In axillary block using 20 ml of 0.5% Levobupivacaine, addition of 300 units of hyaluronidase, reduces onset of sensory and motor block time, reduces the duration of sensory block and time to rescue analgesia.
Authors and Affiliations
Dr. J Bennet Abraham
Keywords
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