A RANDOMIZED STUDY COMPARING THE EFFICACY OF ULTRASOUND GUIDED SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK USING 0.5% BUPIVACAINE ALONE AND COMBINATION OF 0.5% BUPIVACAINE AND BUPRENORPHINE IN PATIENTS UNDERGOING ELECTIVE UPPER LIMB ORTHOPAEDIC SURGERIES

Abstract

Background: Many adjuvants have been tried to enhance the analgesic efficacy of local anaesthetics in supraclavicular brachial plexus block. From previous studies, it was noted that opioids added to local anaesthetics produce comparable analgesia in supraclavicular brachial plexus block. Hence, in my study, I have compared a group of patients who received bupivacaine alone with the other group of patients who received the combination of bupivacaine and buprenorphine. Methods & Methodology: With Institutional ethical committee approval and written informed consent, we conducted double-blind, randomized study with two groups of 30 patients each. The supraclavicular brachial plexus block was performed in elective upper limb surgeries to compare the efficacy of analgesia with 0.5% bupivacaine alone and a combination of 0.5% bupivacaine and buprenorphine in patients undergoing elective upper limb orthopaedic surgeries with respect to onset and duration of blockade. Visual analogue scale (VAS) scores were evaluated at fixed interval for 24 hours postoperatively in all patients. Result:  Onset of motor blockade delayed in group II (9.70 min) compared to group I (9.27min).  VAS score was found to be better in group II (12hrs) than in group I (6-8hrs). Time to first rescue analgesia was prolonged in group II (13.10hrs) than in group I (7.10hrs). Conclusion: The results showed that buprenorphine enhance and prolong the analgesic effect of bupivacaine when used for supraclavicular brachial plexus block in patients undergoing elective upper limb orthopaedic surgeries.