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Category: Volume 08 Issue 11 November 2020
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Title: A study on the efficacy of Levobupivacaine with Buprenorphine in comparison to Levobupivacaine alone in ultrasound guided supraclavicular brachial plexus block

Authors: Arvind­­, Mohd Khalik Ansari, Neeharika Arora, Malti Agrawal, Rampal Singh, Gopal Krishan

 DOI: https://dx.doi.org/10.18535/jmscr/v8i11.15

Abstract

Objective: A clinical study to determine the onset of action & duration of sensory and motor block and to study the duration of analgesia.

Material and Methods: Eighty ASA physical status Grade 1 and 2 patients of either sex, between 18-60 years of age & BMI 18.5- 30 undergoing elective and emergency upper limb surgeries were selected for the study. After a thorough history and examination patients were divided into two groups of 40 each, depending on the drug administration. Group A: It consists of patients who were given 25 ml of 0.5 % Levobupivacaine with 0.5 ml normal saline. Group B: It consists of patients who were given 25 ml of 0.5 % Levobupivacaine with 0.5 ml of Buprenorphine (150µg). The onset time of the sensory and motor blocks; the time required for complete sensory and motor blocks; the total duration of analgesia, the haemodynamic changes and side effects were determined and compared in both the groups.

Results: It was observed that addition of Buprenorphine as an adjuvant to local anesthetics for brachial plexus makes sensory (9.67±2.34 mins) and motor (13.10±3.29 mins) onset earlier than plain local anesthetic agent (sensory 12.45±3.96 mins and motor 14.865±4.08 mins) used. The duration of sensory (8.11±1.58 hrs. and 14.72±3.09 hrs) and motor (10.77±1.57 hrs. and 16.71±3.39 hrs) block was significantly longer in the Buprenorphine group than in the control group (p-value < 0.001). All patients in both groups remained hemodynamically stable with no significant difference in vital parameters at all times. The postoperative pain score and the number of patients who required rescue analgesics and mean number of supplemental analgesics required were also significantly lower in Buprenorphine group as an Adjuvant to local anesthetics.    

Conclusion: It was concluded that the addition of 150µg (0.5 ml.)  of Buprenorphine to 0.5% Levobupivacaine effectively and safely shortens the onset of sensory and motor blockade, increases the duration of sensory and motor blockade and increases the duration of postoperative analgesia without any hemodynamic disturbances.

Keywords: Levobupivacaine, Buprenorphine. Ultrasound, Supraclavicular brachial plexus block, Sensory and motor blockade.

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Corresponding Author

Dr Mohd Khalik Ansari

Assistant Professor, Department of Anaesthesiology, RMCH Bareilly (U.P.) India