Korean J Anesthesiol.  2012 Jan;62(1):24-29. 10.4097/kjae.2012.62.1.24.

Clinical comparisons of 0.5% and 0.375% levobupivacaine for ultrasound-guided axillary brachial plexus block with nerve stimulation

• Kim W
• Kim YJ
• Kim JH
• Kim DY
• Chung RK
• Kim CH
• Heo S

• KMID: 2236447
• DOI: http://doi.org/10.4097/kjae.2012.62.1.24

Abstract

BACKGROUND
In an axillary brachial plexus block (ABPB), where relatively large doses of local anesthetics are administered, levobupivacaine is preferred due to a greater margin of safety. However, the efficacy of levobupivacaine in ABPB has not been studied much. We performed a prospective, double-blinded study to compare the clinical effect of 0.375% levobupivacaine with 0.5% levobupivacaine for ultrasound (US)-guided ABPB with nerve stimulation.
METHODS
Forty patients undergoing elective upper limb surgery were randomized into two groups: Group I (0.375% levobupivacaine) and Group II (0.5% levobupivacaine). All four main terminal nerves of the brachial plexus were blocked separately with 7 ml of levobupivacaine using US guidance with nerve stimulation according to study group. A blinded observer recorded the onset time for sensory and motor block, elapsed time to be ready for surgery, recovery time for sensory and motor block, quality of anesthesia, patient satisfaction and complications.
RESULTS
There were no significant differences in the time to find nerve locations, time to perform block and number of skin punctures between groups. Insufficient block was reported in one patient of Group I, but no failed block was reported in either group. There were no differences in the onset time for sensory and motor block, elapsed time to be ready for surgery, patient satisfaction and complications.
CONCLUSIONS
0.375% levobupivacaine produced adequate anesthesia for ABPB using US guidance with nerve stimulation, without any clinically significant differences compared to 0.5% levobupivacaine.

Keyword

Axillary brachial plexus block; Levobupivacaine; Ultrasonography

MeSH Terms

Anesthesia
Anesthetics, Local
Brachial Plexus
Bupivacaine
Humans
Patient Satisfaction
Prospective Studies
Punctures
Skin
Upper Extremity
Anesthetics, Local
Bupivacaine