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Scholars Journal of Applied Medical Sciences | Volume-4 | Issue-03
A Clinical Evaluation of Bilateral Brachial Plexus Block Using Different Approaches for Upper Limb Orthopaedic Surgeries
Dr. Amit Kumar Jain, Dr. Hansraj Baghel, Dr. Sonal Awasya
Published: March 29, 2016 |
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DOI: 10.36347/sjams.2016.v04i03.044
Pages: 842-844
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Abstract
Surgical anesthesia and analgesia both can be achieved by brachial plexus block for upper limb orthopaedic
surgeries. Adjuvant used to block brachial plexus has fewer side effects and also decrease the total dose of local
anaesthetics being used. To compare the effectiveness of addition of xylocaine with 2% adrenaline mixture versus
bupivacaine 0.5% plane for brachial plexus block in providing perioperative analgesia. The study included 25 patients
scheduled for bilateral upper limb orthopedic surgeries at Gandhi Medical College, Bhopal. Xylocaine and adrenaline
mixture was injected using supraclavicular approach for brachial blockade in first upper limb to be operated, then after
the completion of surgery or after minimum duration of 1 hr other upper limb was blocked using 20 ml of injection
bupivacaine 0.5% plane via axillary approach. Onset and duration of sensory and motor blockade was recorded. Mean
age and weight of patients was 34 ± 10.12 years. Mean onset of sensory block was faster with xylocaine and adrenaline
mixture (3.4±1.5 min) as compared to plain bupivacaine (10.5±2.6 min) whereas mean duration of sensory blockage was
shorter in xylocaine and adrenaline mixture (120±20.5min) as compared to plain bupivacaine (180±50.6 min). Mean
onset of motor block was faster with xylocaine and adrenaline mixture (5.4±3.2min) as compared to plain bupivacaine
(18.2±3.5min) whereas mean duration of sensory blockage was shorter in xylocaine and adrenaline mixture
(110.3±30.8min) as compared to plain bupivacaine (150.2±15.7min). Most common side effect observed was nausea and
vomiting (32%). In bilateral brachial blockade adrenalized xylocaine provided quick onset of sensory and motor block
whereas bupivacaine resulted in to longer duration of sensory and motor block.