Comparison of efficacy of nalbuphine-levobupivacaine combination with levobupivacaine alone in ultrasound-guided supraclavicular brachial plexus block in upper limb orthopedic surgeries
Background and Aims: Brachial plexus block is a widely used approach for upper limb surgeries as an alternative to general anesthesia to achieve ideal operating conditions by providing adequate muscle relaxation and maintaining intraoperative hemodynamic stability. Ultrasound-guided supraclavicular...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2023-01-01
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| Series: | The Indian Anaesthetists' Forum |
| Subjects: | |
| Online Access: | http://www.theiaforum.org/article.asp?issn=2589-7934;year=2023;volume=24;issue=2;spage=103;epage=108;aulast=Qureshi |
| _version_ | 1827269888918421504 |
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| author | Sana Qureshi Veena Mathur Maina Singh Deepak Kumar Garg Pradeep Kumar Kuldeep Jonwal |
| author_facet | Sana Qureshi Veena Mathur Maina Singh Deepak Kumar Garg Pradeep Kumar Kuldeep Jonwal |
| author_sort | Sana Qureshi |
| collection | DOAJ |
| description | Background and Aims: Brachial plexus block is a widely used approach for upper limb surgeries as an alternative to general anesthesia to achieve ideal operating conditions by providing adequate muscle relaxation and maintaining intraoperative hemodynamic stability. Ultrasound-guided supraclavicular brachial plexus block provides intraoperative anesthesia and postoperative analgesia. It reduces many complications such as intravascular injection pneumothorax. Levobupivacaine is preferable over bupivacaine due to its lower cardiotoxicity, prolonged sensory block, and shorter duration of motor block.
Materials and Methods: A prospective, hospital-based, double-blinded, randomized, controlled, comparative study was planned on 80 adult patients of either sex belonging to the American Society of Anesthesiologists Class 1 and 2 undergoing upper limb orthopedic surgeries. Group L – 24 mL levobupivacaine 0.375% (90 mg) + NS (1 mL) (total volume 25 mL) and Group LN – 24 mL levobupivacaine 0.375% (90 mg) +5 mg nalbuphine diluted with NS to 1 mL volume (total volume 25 mL). Duration of analgesia, onset, and duration of sensory block and motor block, hemodynamic changes, and total doses of rescue analgesia in 24 h were noted in both groups.
Results: The duration of analgesia was significantly longer in Group LN (749.80 ± 9.70 min) as compared to Group L (641.20 ± 12.71 min) (P < 0.001). Onset of sensory block in Group LN (11.15 ± 0.83 min) is faster than in Group L is (13.30 ± 0.52 min) (P < 0.001). Onset of motor block in Group LN (13.68 ± 0.73 min) is faster than in Group L (16.33 ± 0.89 min) (P < 0.001). Hemodynamic parameters were comparable in both groups. There was no significant difference in adverse effects and complications.
Conclusion: The addition of nalbuphine to levobupivacaine provides a longer duration of analgesia as compared to levobupivacaine alone. |
| first_indexed | 2024-03-08T13:10:55Z |
| format | Article |
| id | doaj.art-05cb051178ff432f90d0adace2d5157c |
| institution | Directory Open Access Journal |
| issn | 0973-0311 |
| language | English |
| last_indexed | 2025-03-22T05:12:42Z |
| publishDate | 2023-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | The Indian Anaesthetists' Forum |
| spelling | doaj.art-05cb051178ff432f90d0adace2d5157c2024-04-27T05:53:43ZengWolters Kluwer Medknow PublicationsThe Indian Anaesthetists' Forum0973-03112023-01-0124210310810.4103/TheIAForum.TheIAForum_13_23Comparison of efficacy of nalbuphine-levobupivacaine combination with levobupivacaine alone in ultrasound-guided supraclavicular brachial plexus block in upper limb orthopedic surgeriesSana QureshiVeena MathurMaina SinghDeepak Kumar GargPradeep KumarKuldeep JonwalBackground and Aims: Brachial plexus block is a widely used approach for upper limb surgeries as an alternative to general anesthesia to achieve ideal operating conditions by providing adequate muscle relaxation and maintaining intraoperative hemodynamic stability. Ultrasound-guided supraclavicular brachial plexus block provides intraoperative anesthesia and postoperative analgesia. It reduces many complications such as intravascular injection pneumothorax. Levobupivacaine is preferable over bupivacaine due to its lower cardiotoxicity, prolonged sensory block, and shorter duration of motor block. Materials and Methods: A prospective, hospital-based, double-blinded, randomized, controlled, comparative study was planned on 80 adult patients of either sex belonging to the American Society of Anesthesiologists Class 1 and 2 undergoing upper limb orthopedic surgeries. Group L – 24 mL levobupivacaine 0.375% (90 mg) + NS (1 mL) (total volume 25 mL) and Group LN – 24 mL levobupivacaine 0.375% (90 mg) +5 mg nalbuphine diluted with NS to 1 mL volume (total volume 25 mL). Duration of analgesia, onset, and duration of sensory block and motor block, hemodynamic changes, and total doses of rescue analgesia in 24 h were noted in both groups. Results: The duration of analgesia was significantly longer in Group LN (749.80 ± 9.70 min) as compared to Group L (641.20 ± 12.71 min) (P < 0.001). Onset of sensory block in Group LN (11.15 ± 0.83 min) is faster than in Group L is (13.30 ± 0.52 min) (P < 0.001). Onset of motor block in Group LN (13.68 ± 0.73 min) is faster than in Group L (16.33 ± 0.89 min) (P < 0.001). Hemodynamic parameters were comparable in both groups. There was no significant difference in adverse effects and complications. Conclusion: The addition of nalbuphine to levobupivacaine provides a longer duration of analgesia as compared to levobupivacaine alone.http://www.theiaforum.org/article.asp?issn=2589-7934;year=2023;volume=24;issue=2;spage=103;epage=108;aulast=Qureshibrachial plexus blocklevobupivacainenalbuphinepostoperative analgesia |
| spellingShingle | Sana Qureshi Veena Mathur Maina Singh Deepak Kumar Garg Pradeep Kumar Kuldeep Jonwal Comparison of efficacy of nalbuphine-levobupivacaine combination with levobupivacaine alone in ultrasound-guided supraclavicular brachial plexus block in upper limb orthopedic surgeries The Indian Anaesthetists' Forum brachial plexus block levobupivacaine nalbuphine postoperative analgesia |
| title | Comparison of efficacy of nalbuphine-levobupivacaine combination with levobupivacaine alone in ultrasound-guided supraclavicular brachial plexus block in upper limb orthopedic surgeries |
| title_full | Comparison of efficacy of nalbuphine-levobupivacaine combination with levobupivacaine alone in ultrasound-guided supraclavicular brachial plexus block in upper limb orthopedic surgeries |
| title_fullStr | Comparison of efficacy of nalbuphine-levobupivacaine combination with levobupivacaine alone in ultrasound-guided supraclavicular brachial plexus block in upper limb orthopedic surgeries |
| title_full_unstemmed | Comparison of efficacy of nalbuphine-levobupivacaine combination with levobupivacaine alone in ultrasound-guided supraclavicular brachial plexus block in upper limb orthopedic surgeries |
| title_short | Comparison of efficacy of nalbuphine-levobupivacaine combination with levobupivacaine alone in ultrasound-guided supraclavicular brachial plexus block in upper limb orthopedic surgeries |
| title_sort | comparison of efficacy of nalbuphine levobupivacaine combination with levobupivacaine alone in ultrasound guided supraclavicular brachial plexus block in upper limb orthopedic surgeries |
| topic | brachial plexus block levobupivacaine nalbuphine postoperative analgesia |
| url | http://www.theiaforum.org/article.asp?issn=2589-7934;year=2023;volume=24;issue=2;spage=103;epage=108;aulast=Qureshi |
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