COMPARISON OF TWO DIFFERENT VOLUMES OF 0.5% LEVOBUPIVACAINE FOR CLAVICULAR SURGERIES USING COMBINED INTERSCALENE AND SUPERFICIAL CERVICAL PLEXUS BLOCK

Abstract

CONTEXT: The use of ultrasound in regional anaesthesia has resulted in reduction in local anaesthetic volume and
adverse effects.
AIMS: This study aims to compare the quality of analgesia and incidence of adverse effects using two different volumes of
0.5% levobupivacaine for clavicular surgeries by ultrasound guided combined interscalene and superficial cervical plexus
block.
SETTINGS AND DESIGN: randomized controlled double blinded interventional study
Methods and Material:60 patients undergoing clavicular surgery were randomized to receive ultrasound guided
interscalene block of either 10 ml(group L)or 20 ml(Group H) of 0.5% levobupivacaine and 5 ml of 0.5% levobupivacaine
for superficial cervical plexus block. Both the groups were assessed for quality of intraoperative and postoperative
analgesia by sensory,motor block. Hemidiaphragmatic paresis was assessed by ultrasound guided diaphragmatic
movement.
Statistical analysis used:Continuous variable by student’s t test and non parametric data by fisher’s exact test.
RESULTS: Adequacy of intraoperative anesthesia and analgesia was comparable in both the groups (p – 1.00).
Phrenic nerve palsy was present in 6 patients of group H whereas none of the patients of group L developed phrenic nerve
palsy (p – 0.023). There was no requirement of supplementation of analgesics in both the groups intraoperatively. The
duration of postoperative analgesia was 5.78  0.4 hours in group L and 5.7  0.4 hours in group H (p -0.459)
CONCLUSIONS:
Comparable quality of intraoperative and postoperative analgesia and reduced incidence of hemidiaphragmatic paresis can
be obtained with 10 ml compared to 20 ml of 0.5% levobupivacaine.