Comparison of post operative analgesia supraclavicular brachial plexus block in children 5 to 10 years of age

Abstract

Background: Regional anesthesia is a recommended technique for upper limb surgeries with better postoperative profile.However paediatric regional anaesthesia for upper limb surgeries was till now difficult due to various problems like moving child ,inability to elicit parasthesia and likely injury to brachial plexeus. With the advent of nerve stimulators and ultrasound guided blocks ,we can now overcome the above problems . We evaluated the effect of ultrasound guided bupivacaine for quality and duration of post op analgesia. Methodology: Sixty paediatric patients posted for elective and emergency upper limb surgeries were enrolled for a prospective, randomized, study . Patients were divided into two groups, the control group A and the study group B.In group A (n =30) patients were given general anaesthesia for the surgery and at the end of it, conventional analgesics were given and In group B (n = 30),after GA , 10 ml of 0.325% bupivacaine + normal saline were given ultrasound guided supraclavicular brachial plexus block. Quality and duration of post op analgesia and time to first rescue analgesia were recorded. Results. The onset times for pain was significantly shorter in A than B group (p < 0.05). The duration of analgesia (DOA) was significantly longer in B group than A group (p < 0.0001).Heart rate levels in group B were significantly lower 15 min after block (p< 0.001). SBP and DBP levels in B group were significantly lower than in A (p < 0.001). No major adverse effects were observed in either of the groups except for sedation 8 and respiratory depression in 6 patients of group A. Conclusion: Supraclavicular brachial plexus block significantly lengthens the onset time of pain and prolongs the duration of post op analgesia. Patients in group B had good quality analgesia with no adverse effects.