EAJAIC
Eurasian Journal of Anesthesiology and Intensive Care

The Eurasian Journal of Anesthesiology and Intensive Care (EAJAIC) is an independent-unbiased, peer-reviewed, "double-blind", and open-access journal of current national and international issues and reviews for original clinical and experimental research, interesting case reports, differential diagnoses, editorial opinions, letters to the editor, and educational papers in anesthesiology, algology, and intensive care medicine.

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eISSN: 3023-6738
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Original Article
Comparison of bupivacaine and levobupivacaine in continuous axillary brachial plexus block
Abstract
Aims: This study compares bupivacaine – lidocaine and levobupivacaine – lidocaine administrations in terms of initiation and duration of motor and sensorial blockage, total number of additional analgesic applications, analgesic amount consumed in 24 hours, side-effects and hemodynamic effects in continuous axillary brachial pleksus block in hand and forearm surgery.
Methods: Thirty ASA I & II physical status patients, scheduled hand or forearm surgery were enrolled for of the two groups in a randomized study. Axillary catheter duly placed in both group with appropriate guided techniques. Patients in group B received 0. 5% bupivacaine 20 ml + 2% lidocaine 20 ml and group L received 0. 5% levobupivacaine 20 ml + 2% lidocaine 20 ml through the axillary catheter. Initiation and duration of motor and sensorial block, total number of additional analgesic applications and analgesic amount consumed in postoperative 24 hours were recorded. Pre-block, peri-operative and post-operative blood pressures and heart beat rates were also recorded. Block application duration, operation duration, tourniquet duration and demographic data of patients (age, sex, weight, and length) were recorded. Demanded and applied analgesic doses by the patient controlled analgesia devices, side effects and complications were also recorded.
Results: There was no statistically significant difference between two groups in terms of initiation and duration of motor and sensorial block, amount of analgesic consumed in 24 hours, demanded and applied analgesic doses by the patient controlled analgesia devices and hemodynamic data (p>0. 05). There is a mild and positive relation between block application duration and patient weight. (p=0. 014; r=0. 444)
Conclusion: Both bupivacaine+lidocaine and levobupivacaine+lidocaine combinations can safely be used in axillary continuous brachial plexus block without any difference in terms of initiation and duration of block, total analgesic amount consumed. Their duration of action and effect on hemodynamic responses are similar.

Keywords : Axillary brachial plexus blockage, continuous brachial plexus block- age, bupivacaine, levobupivacaine.

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1. Lee S, Kim MK, Ahn E, Jung Y. Comparison of general and regionalanesthesia on short-term complications in patients undergoing totalknee arthroplasty: a retrospective study using national health insuranceservice-national sample cohort. Medicine. 2023;102(8):e33032.
2. Wedel DJ, Horlocker TT. Nerve Blocks. In: Miller RD, ed. Anesthesia.6th ed. Churchill Livingstone: 2005:1685-1719.
3. McCartney CJ, Brull R, Chan V, et al. Early but no long-term benefitof regional compared with general anesthesia for ambulatory handsurgery. J Am Soc Anesthesiol. 2004;101(2):461-467.
4. Özgüner Y, Alptekin A. Comparison of rebound pain and postoperativetramadol requirement in patients who had femoral nerve block oradductor canal block for pain after total knee arthroplasty. JARSS.2021;29(4):254-262.
5. Clifford SP, Maggard BD, Hines KM. Prolonged continuousinfraclavicular brachial plexus perineural infusion followingreplantation of a mid-humeral amputation. SAGE Open Med Case Rep.2019;7:2050313x18823094.
6. Hadzic A, Arliss J, Kerimoglu B. A comparison of infraclavicular nevreblock versus general anesthesia for hand and wrist daycase surgeries. JAm Soc Anesthesiol. 2004;101(1):127-132.
7. Cline E, Franz D, Polley RD, Maye J, Burkard J, Pellegrini J. Analgesiaand effectiveness of levobupivacaine compared with ropivacainein patients undergoing an axillary brachial pleksusblock. AANA J.2004;72(5):339-345.
8. Cox CR, Checketts MR, Mackenzie N, Scott NB, Bannister J.Comparison of S (-) bupivacaine with racemic (RS) bupivacaine insupraclavicular brachial pleksusblock. Br J Anaesth. 1998;80(5):594-598.
9. Goldberg ME, Gregg C, Larijani GE, Norris MC, Marr AT, SeltzerJL. A comparison of three methods of axillary approach to brachialpleksusblockade for upper extremity surgery. J Am Soc Anesthesiol.1987;66(6):814-815.
10. Tuominen MK, Pitkaenen MT, Numminen MK, Rosenberg PH.Quality of axillary brachial pleksusblock: comparison of success rateusing perivascular and nerve stimulator techniques. Anaesthesia.1987;42(1):20-22.
11. Vester Andersen T, Husum B, Lindeburg T. Perivascular axillaryblock 4 blockade following 40, 50 or 60 mL of mepivacaine %1 withadrenaline. Acta Anaesthesiol Scand. 1984;28(1):99-105.
12. Schroeder LE, Horlocker TT, Schroeder DR. The efficacy of axillary blockfor surgical procedures about elbow. Anesth Analg. 1996;83(4):747-751.
13. Sato RTC, Porsani DF, Amaral AGV, Júnior OVS, Carstens AMG.Comparative study of 0.5% racemic bupivacaine versus enantiomericmixture (S75-R25) of 0.5% bupivacaine in brachial pleksusblock fororthopedic surgery. Rev Bras Anestesiol. 2005;55(2):165-174.
14. Casati A, Chelly JE, Cerchierini E, et al. Clinical properties oflevobupivacaine or racemic bupivacaine for sciatic nerve block. J ClinAnesth. 2002;14(2):111-114.
15. Liisanantti O, Luukkonen J, Rosenberg PH. High-dose bupivacaine,levobupivacaine and ropivacaine in axillary brachial pleksusblock.Acta Anaesthesiol Scand. 2004;48(5):601-606.
16. Cox CR, Faccenda KA, Gilhooly C, Bannister J, Scott NB, MorrisonLM. Extradural S (-)-bupivacaine: comparison with racemic RS-bupivacaine. Br J Anaesth. 1998;80(3):289-293.
17. Ozmen S, Ozmen OA, Kasapoglu F. Effects of levobupivacaine versusbupivacaine infiltration on postoperative analgesia in pediatrictonsillectomy patients: a randomized, double-blind, placebo-controlledstudy. Ann Otol Rhinol Laryngol. 2011;120(7):489-493.
18. Cox B, Durieux ME, Marcus MA. Toxicity of local anaesthetics. BestPract Res Clin Anaesthesiol. 2003;17(1):111-136.
19. Urban MK, Urguhart B. Evaluation of brachial pleksusanesthesia forupper extremity surgery. Reg Anesth. 1994;19(3):175-182.
20. Palve H, Kirvela O, Olin H, Syvalahti E, Kanto J. Maximumrecommended doses of lignocaine are not toxic. Br J Anaesth.1995;74(6):704-705.
21. Aantaa R, Kirvelae O, Lahdenperae A. Transarterial brachialpleksusanesthesia for hand surgery: a retrospective analysis of 346cases. J Clin Anesth. 1994;6(3):189-192.
22. Selander D. Axillary pleksusblock: paresthetic or perivascular.Anesthesiol. 1987;66(6):726-728.
23. Viderman D, Ben-David B, Sarria-Santamera A. Analysis ofbupivacaine and ropivacaine-related cardiac arrests in regionalanesthesia: a systematic review of case reports. Rev Esp AnestesiolReanim (Engl Ed). 2021;68(8):472-483.
Article available in :
Volume 1, Issue 1, 2024
Page : 11-15
https://doi.org/10.51271/EAJAIC-0003
Article Information
Received : 18 Oca 2024
Accepted : 04 Şub 2024
Published : 12 Şub 2024
Corresponding Author :

Savaş Altınsoy: Ankara Etlik City Hospital Department of Anesthesiolgy and Reanimation

[email protected]
Citation : Altınsoy S, Can A, İnan G, Sayın MM, Özlü O. Comparison of bupivacaine and levobupivacaine in continuous axillary brachial plexus block. Eur J Anesthesiol Intensive Care. 2024;1(1):11-15.

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