DOI: 10.36347/sjams.2019.v07i01.038

Pages: 212-216

Peripheral nerve blocks provide surgical anaesthesia and prolonged postoperative analgesia for upper limb surgeries. Compared to general anaesthesia, blocks provide sympathetic blockade, lesser incidence of PONV and cognitive disorders. Ultrasound guided supraclavicular brachial plexus block provides dense anaesthesia for surgeries of the forearm and hand. Brachial plexus is compact at supraclavicular region and pneumothorax as possible complication, can be eliminated by using US guidance. Many centres advocate this anaesthetic approach as gold standard for upper limb orthopaedic surgeries. Pharmacologically, Levobupivacaine is considered longer lasting than Ropivacaine. However, previous reports do not suggest a difference in analgesic effect when Levobupivacaine is used for brachial plexus blocks compared with ropivacaine, except for a single report. We compared 20mL 0.5% Levobupivacaine with 20mL 0.5% Ropivacaine when used for ultrasound guided supraclavicular brachial plexus nerve blocks in patients undergoing upper limb orthopedic surgery. A prospective comparative observational study involving forty patients aged 18-65years, ASA grade I & II, belonging to either sex divided into two groups, group L(n=20) and group R(n=20). Time of onset and duration of sensory and motor block, postoperative 2 hourly VAS scores, adverse effects were assessed. No significant difference in onset of sensory block (group L: 5.36+1.18min; group R: 5.74+1.25min; p>0.05) and motor block (group L: 7.11+1.07min; group R: 7.62+1.23min; p>0.05). Significantly longer duration of sensory block in group L (6.83+1.67hours) than group R (5.78+1.34hours), p=0.03 and significantly longer motor block in group L (6.13+1.14hours) than group R (4.35+1.56hours), p<0.001.