Evaluation of analgesic properties of verapamil as an adjuvant with 0.25% bupivacaine in USG guided supraclavicular brachial plexus block

Abstract

Background: Peripheral nerve blocks are extensively preferred in perioperative pain management. Adding calcium blockers to local anesthetics agents can prolong the duration of analgesia. Verapamil, a calcium channel blocker is used extensively as an adjunct to lignocaine or bupivacaine for brachial plexus block due to its prolonged duration of action. This study was designed to evaluate whether additional anaesthetic and analgesic effect could be derived from administration of verapamil to 0.25% bupivacaine in supraclavicular brachial plexus block. Material and Methods: A total of 76 cases underdoing upper limb surgeries between age group 21 to 65 years belong to ASA grade I and II were recruited. Cases were randomly divided into 2 groups i.e. group 1 with USG guided brachial plexus block using 30ml of 0.25% bupivacaine with 2ml of normal saline and group 2 with 30 ml of 0.25% bupivacaine with 5mg of verapamil diluted to 2ml. Parameters like pulse rate, blood pressure, Spo2 were recorded before and after the block. Results: The mean difference of onset and duration of sensory and motor blockade between two study groups was statistically significant (P<0.005). The mean difference of duration of rescue analgesia was statistically significant between two study groups (P<0.003). The mean pulse rate, systolic blood pressure, diastolic blood pressure and oxygen saturation levels was comparable between two study groups and mean difference was statistically not significant (p>0.005). Conclusion: Verapamil as an adjunct to 0.25% bupivacaine in supraclavicular brachial plexus block acts efficiently in maintaining prolonged duration of analgesia.