Effects Of Bupivacaine And Buprenorphine On Postoperative Analgesia In A Nerve Stimulator-Guided Supraclavian Plexus Block: A Randomised, Double-Blind Comparison Study

Abstract

There have been several attempts to find an adjuvant that would increase the analgesic effectiveness of local anaesthetics in supraclavicular brachial plexus blocks. Previous research has shown that supraclavicular brachial plexus blocks that include opioids in addition to local anaesthetics provide analgesia that is equivalent to that of the two methods alone. As a result, I've contrasted two groups of patients in my study: one that got bupivacaine alone, and another that got a mix of the two.
The purpose of this research is to evaluate the efficacy of bupivacaine alone and bupivacaine with buprenorphine for postoperative pain management in nerve stimulator guided supraclavicular brachial plexus blocks.
Looking Forward to Sixty patients participated in the 18-month, randomised, double-blind control trial that took place from March 2021 to August 2022 at the Khaja Banda Nawaz Teaching and General Hospital in Kalaburagi. Thirty patients each were assigned to one of two groups.
The first group had 15 millilitres of 2% lignocaine with adrenaline, 20 millilitres of 0.5 percent bupivacaine, and 5 millilitres of normal saline.
Fluids administered to Group B consisted of 15 ml of Inj.2% Lignocaine with Adrenaline, 20 ml of Inj.0.5% Bupivacaine, and 3 mcg/kg of Inj. Buprenorphine diluted to 5 ml with Normal Saline.
The time it took for sensory blockage to begin in Group A was 9.70 minutes, whereas in Group B it was 9.26 minutes. The sensory blockage in Group A lasted 329.17 minutes, whereas in Group B it lasted 586.83 minutes. Both groups had comparable onset of motor blockage. Group B's time was 11.50 minutes, while Group A's was 11.67 minutes. Both Group A and Group B had motor block durations of 299.5 and 299.16 minutes, respectively. Group A's analgesia lasted 5.04 hours, whereas Group B's was 10.7 hours. Group A required rescue analgesics after 7.1 hours, whereas Group B required them after 13.1 hours. The hemodynamic parameters were similar across the two groups.
Patients having operations on their upper limbs might benefit from a supraclavicular brachial plexus block with bupivacaine and buprenorphine because the former increases and the latter prolongs the analgesic impact of the latter.