COMPARATIVE CLINICAL TRIAL SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK WITH BUPIVACAINE AND LEVOBUPIVACAINE

Abstract

Objective: To examine the onset, intensity, duration, and analgesic effects of Bupivacaine and Levobupivacaine in 
supraclavicular brachial plexus block. Additionally, to assess the frequency of blockade failure and related side effects.  
Methods: A prospective, randomised, double-blind research including 100 patients scheduled for arm and forearm 
procedures was conducted. Two groups of fifty patients each were randomly assigned to the patients. Patients in Group 
B received 30 millilitres of Bupivacaine Hcl (0.5%), whereas those in Group L received 30 millilitres of 
Levobupivacaine Hcl (0.5%). Monitoring was done on heart rate, NIBP, respiratory rate, and oxygen saturation (SpO2).  
Premedication with injections of 4 mg of Ondansetron and 50 mg of ranitidine intravenously were administered to each 
patient. Following the conclusion of the block, each patient received an IV injection of 1 mg of midazolam. The 
duration and degree of sensory and motor blockage, the length of time that effective analgesia was provided, 
hemodynamic changes, side effects, and complications were all monitored in all of the patients. 
Results: The two groups' respective times of sensory and motor blockage onset were similar. The timing of sensory 
blockage start (p=0.0521) was not statistically significant. There was no statistically significant difference in the time of 
motor blockage onset (p=0.534). The majority of patients in both groups received a grade 2 block. The length of the 
motor and sensory blocks was similar in both groups. The sensory block's mean duration (p=0.0987) did not show 
statistical significance. Likewise, the length of the motor block did not reach statistical significance (p=0.0801). The 
average length of analgesia (p = 0.0895) did not show statistical significance. The length of analgesia in both groups 
was comparable. Every subject had their hemodynamic parameters and any adverse effects noted.  
Conclusion: neither group showed any appreciable changes during the course of the research. The most comprehensive 
limb block is achieved with brachial plexus blocks using the supraclavicular technique. This method offers the most homogenous block with the least amount of chance of proximal or peripheral nerve branch loss. Brachial plexus block 
has been achieved with a variety of local anaesthetics. When used in peripheral nerve blocks, bupivacaine, a local 
anaesthetic of the amide group, offers a prolonged duration of anaesthesia and analgesia.