Analgesic Efficacy of Ultrasound Guided Supraclavicular Brachial Plexus Block with Levobupivacaine and Dexmedetomidine for Forearm and Hand Surgeries – A Case Series

Abstract

Periphery nerve blockade is the most common technique used for upper limb surgeries. Newer local anesthetics like levobupivacaine and ropivacaine are gaining popularity as they cause less hemodynamic changes. So, we conducted this case series to know the efficacy of ultrasound guided supraclavicular brachial plexus block with 20ml 0.5% levobupivacaine along with 20µg dexmedetomidine. After obtaining institutional ethics committee approval and written informed consent, we included 15 patients, belonging to ASA PS 1,2, posted for elective forearm and hand surgeries. After getting shifted to ot, 18G intravenous cannula was secured, monitors – ECG, saturation probe, non- invasive blood pressure were connected. Then ultrasound guided supraclavicular block was given using 20ml of 0.5% levobupivacaine with 20µg dexmedetomidine. Motor and sensory block was assessed 30 minutes after giving the block. General anesthesia was given if the block was failed. Hemodynamic parameters were noted every 5min for the first 30min, then every 10 minutes till the end of the procedure. After shifting to postoperative icu, analgesia was assessed using VAS score at 0,6,12,24 hrs. Tramadol 1mg/kg intravenous was given when the score was more than 5. Duration of analgesia was defined as the time between the block and the request for first analgesic in the postoperative period. We observed that the mean duration of analgesia was 938.67 ± 147.9 (mean ± SD). We concluded that ultrasound guided supraclavicular block using 0.5% levobupivacaine with 20 µg dexmedetomidine provides prolonged and effective analgesia without any haemodynamic changes.