“SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK WITH BUPIVACAINE AND LEVOBUPIVACAINE: A COMPARATIVE STUDY”

Abstract

Objective: To compare Bupivacaine and Levobupivacaine in supraclavicular brachial plexus block in terms of onset, degree, duration of sensory and motor blockade and analgesia and also to compare the prevalence of failure of blockade and its adverse effects.

Methods: This was a prospective randomized double blind study which was done on 100 patients who were scheduled for arm and forearm surgeries. Patients were randomly divided into two groups of 50 patients. Group B: patients were given 30 ml of Bupivacaine Hcl (0.5%) and Group L: patients were given 30 ml of Levobupivacaine Hcl (0.5%). Heart rate, NIBP, respiratory rate and oxygen saturation (SpO₂) were monitored. All the patients were premedicated with injection Ranitidine 50 mg IV and injection Ondansetron 4 mg IV. Injection Midazolam 1mg IV administered to all the patients after completion of block. All the patients were observed for onset of sensory and motor blockade, duration of sensory and motor blockade, degree of sensory and motor blockade, duration of effective analgesia, hemodynamic changes, side effects and complications.

Result and interpretation: Time of onset of sensory and motor blockade was comparable between both groups. The time of onset of sensory blockade was not statistically significant (p=0.0521). The time of onset of motor blockade was not statistically significant (p=0.534). Maximum patients achieved grade 2 block in both the groups. Duration of sensory and motor block was comparable in both the groups. Mean duration of sensory block was not statistically significant (p=0.0987). Similarly duration of motor block was not statistically significant (p=0.0801). Mean duration of analgesia was not statistically significant (p = 0.0895). Both the groups were comparable in terms of duration of analgesia. Hemodynamic parameters and any side effects were observed in all the patients.

Conclusion: There were no significant changes reported in both the groups during entire study period.

Keywords: Anaesthesia, Bupivacaine, Levobupivacaine, supraclavicular brachial plexus block, Midazolam, Ondansetron.