A Clinical Evaluation of Bilateral Brachial Plexus Block Using Different Approaches for Upper Limb Orthopaedic Surgeries
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2016, Vol 4, Issue 3
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. Keywords: bilateral brachial blockade, xylocaine and adrenaline mixture, orthopaedic surgeries.
Authors and Affiliations
Dr. Amit Kumar Jain, Dr. Hansraj Baghel, Dr. Sonal Awasya
Keywords
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