This study was aimed to assess the efficacy of patient controlled analgesia using continuous infraclavicular brachial plexus in upper limb surgeries, to study the amount of rescue analgesics used and to study the associated complications and sleep disturbances in patients underwent upper extremity orthopaedic surgery. MATERIALS AND METHODSA prospective randomized clinical study was done on 60 patients undergoing upper limb below mid shaft of humerus surgeries. Sixty patients belonging to ASA-Physical status 1-2 were selected for study and randomly allocated to two groups of 30 each. Group A received patient controlled analgesia with continuous infusion of 0.2% ropivacaine through infraclavicular catheter (P Group). Group B received patient controlled analgesia with continuous infusion of 0.9% normal saline through infraclavicular catheter (C Group). RESULTSPatients received ropivacaine experienced significantly less postoperative pain compared with patients received normal saline during rest at all-time intervals except at the baseline. Patients in the C group received first top-up in 5-6 hours, whereas 6 patients in the P group received their first top-up after 10 hours and 22 patients received after 12 hours. In the Group P, patients experienced no sleep disturbances compared to the placebo group. CONCLUSIONThis randomized, double-blinded, placebo-controlled study shows us that postoperative analgesia is achievable using a perineural infusion of ropivacaine via an infraclavicular brachial plexus catheter after moderately painful upper extremity surgery. Hence, patients experienced a significant decrease in sleep disturbances, analgesic use and narcotic-related side effects.

Presenting here, the effectiveness of combined lumbar plexus and sciatic nerve block in femoro-popliteal and femoro-tibial bypass surgeries. Patients were stable throughout the procedure and postoperatively with no complaints of pain.

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