Supraclavicular Brachial Plexus Block: A Comparative Clinical Study between Bupivacaine and Levobupivacaine
Journal Title: Indian Journal of Anesthesia and Analgesia - Year 2017, Vol 4, Issue 1
Abstract
The racemic bupivacaine is commonly used local anaesthetic drug brachial plexus block in as it provides longer duration of action but has risk of cardiotoxicity .The use of levobupivacaine in brachial plexus block seems promising considering its lower toxicity and the need of large volumes in this block. However there is possibility of unsatisfactory motor blockade. Aim: To compare the efficacy and side effects of bupivacaine and levobupivacaine in brachial plexus block by supraclavicular approach. brachial plexus block Methods: This study included 60 patients belonging to ASA grade I and II, either sex, between age group of 18 to 65 years and above, undergoing hand, forearm and arm surgery under supraclavicular block. These patients were randomly divided into two groups. The patients received 30 ml 0.5% bupivacaine (Group B) or 30 ml 0.5% levobupivacaine (Group L). Motor and sensory blocks were evaluated. Sensory and motor block onset times, durations of sensory and motor block and duration of postoperative analgesia were recorded. Results: The two study groups were homogeneous with respect to age, sex, body weight and diagnosis type (type of fractures) and duration of surgery. The sensory and motor block onset times in Group B were significantly shorter than Group L (p < 0.05). The onset of sensory block was 9.33 + 3.27 min. in group B whereas, it was 16.13 + 2.83 min. in group L. The onset of motor block was 12.17 + 2.18 in group B, whereas it was 20.00 + 2.79 in group L. Sensory and motor block durations of Group B and L patients did not vary statistically significantly. In the present study, the mean duration of post operative analgesia was statistically insignificant between the two group (p= 0.766). It was 193.56 + 23.51 in group B and 192.83 + 23.54 in group L. Conclusion: 30 ml 0.5% bupivacaine and levobupivacaine was enough to achieve adequate supraclavicular block. Bupivacaine leads to faster sensory and motor block onset compared to levobupivacaine; however it has similar duration of postoperative analgesia.
Authors and Affiliations
Shailendra D. Chauhan
Keywords
Related Articles
- EP ID EP462229
- DOI 10.21088/ijaa.2349.8471.4117.3
- Views 165
- Downloads 0
Comparative Evaluation of Intrathecal Dexmedetomidine with Fentanyl as an Adjuvant to Hyperbaric Bupivacaine in Lower-Limb Orthopaedic Surgeries
Background: Spinal anesthesia is an age old, tested, effective and economical technique of regional anaesthesia especially for lower-limb orthopaedic surgeries because of its excellent muscle relaxation and intraoperativ...
Effect of Oral Clonidine as a Premedication in Patients Receiving Spinal Anaesthesia with Hyperbaric Bupivacaine
Background: Spinal anaesthesia is the most commonly used technique for infraumbilical surgeries. Hyperbaric Bupivacaine has limited duration of action. Clonidine has been used to prolong the duration of local anaesthetic...
Perioperative Airway Management in Deep Neck Space Infections
Introduction: Airway management in deep neck infection are contraversial. In our study we retrospectively reviewed perioperative airway management methods practiced in the last 30 consecutive cases of deep neck infection...
Comparision of Bupivacaine with and without Clonidine as for Supraclavicular Approach to Brachial Plexus Block
Introduction: The role of peripheral nerve blockade was expanded for management of post operative pain and chronic pain. Tramadol and fentanyl had been successfully used as adjuvant to local anaesthetic in brachial plexu...
A Prospective Observational Analytical Study to Evaluate the Variability of Skin Epidural Depth at Various Lumbar Spinal Levels Using Ultrasound
Background: Epidural placement in lumbar spine is used to provide anaesthesia for surgeries below umbilicus. However the success depends on correct identification of epidural space taking into consideration anatomic vari...