English

Abstract

BACKGROUND Regional blocks remain as a widely-accepted essential component of comprehensive anaesthesia care. Peripheral nerve blocks with local anaesthetics provide good operating conditions. However, even with the longest acting local anaesthetics, the duration of analgesia may not be sufficient. So, various drugs are used as an adjuvant to local anaesthetic to enhance analgesic efficiency and the duration of the block. This study was done to determine the analgesic efficacy of nalbuphine with bupivacaine (0.5 %) compared to bupivacaine (0.5 %) alone in supraclavicular brachial plexus block under USG guidance for various elective upper limb surgeries. METHODS This study was carried out in 60 adult patients of ASA grade I/II of either sex, between 18-50 years of age posted for various elective upper limb surgeries. The patients were randomly allocated into two groups; each group containing 30 patients. Group B: received Inj. bupivacaine 0.5 % 20 ml and 1 ml normal saline, Group N: received Inj. bupivacaine 0.5 % 20 ml and Inj. nalbuphine 1 ml (10 mg). Onset and duration of motor and the sensory blocks were accessed. Intraoperative and postoperative hemodynamic monitoring was done. Intraoperative and postoperative complications were noted. RESULTS Nalbuphine added to bupivacaine for supraclavicular approach of brachial plexus block hastened the onset of sensory and motor block, but it was not statistically significant (P > 0.05). However, it prolonged the duration of sensory and motor blocks (P < 0.0001). The mean duration of analgesia was significantly longer in Group N (578.73 ± 23.77 min) than in Group B (470.83 ± 11.73 min) (P < 0.0001). CONCLUSIONS In conclusion, the addition of nalbuphine to bupivacaine in the ultrasound-guided supraclavicular approach of brachial plexus block produces adequate anaesthesia with prolonged duration of sensory and motor blockade and postoperative analgesia. KEY WORDS Bupivacaine, Nalbuphine, Supraclavicular Brachial Plexus Block.