BACKGROUND & AIMS: supraclavicular brachial plexus block is usually used to anaesthetize the upper limb for the purpose of upper limb surgeries. Drugs like Lignocaine, Bupivacaine are used for this block and some additives are added to prolong the duration and quality of blockade. The present study is aimed to evaluate the comparison of plain lignocaine and lignocaine with sodium bicarbonate in supraclavicular brachial plexus block by means of the onset time of sensory and motor blockade, the quality of sensory and motor blockade, and the duration of blockade. METHODS: Sixty patients aged between 18 and 60 years of physical status ASA 1 and 2 undergoing upper limb surgeries lasting more than 30 minutes were included in the study. The patients were randomly allocated into two groups. Supraclavicular brachial plexus block was performed after eliciting paraesthesia. The patients in Group I (n=30) received 25ml of 1% plain lignocaine (prepared by adding 12.5ml of distilled water to 12.5ml of 2% plain lignocaine. The patients in the Group II (study group) received 25ml of 1% alkalinized lignocaine (prepared by adding 3ml of 7.5% sodium bicarbonate and 9.5ml of distilled water to 12.5ml of 2% plain lignocaine). RESULTS: The present study entitled Comparison of effects of plain lignocaine and lignocaine with sodium bicarbonate on brachial plexus block concludes that, the onset time of sensory and motor blockade is lesser with sodium bicarbonate added lignocaine (4.13, 11.1minutes) when compared to plain lignocaine(9.73, 21.1minutes) in supraclavicular brachial plexus block, the quality of sensory and motor blockade is better with sodium bicarbonate added lignocaine, the duration of motor and sensory blockade was significantly prolonged when lignocaine with sodium bicarbonate was used in supraclavicular brachial plexus block.

Background: percutaneous nephrolithotomy (PCNL) is a minimally invasive surgery to treat renal stones. Post-operative pain is distressing to the patient due to the injury to the capsule. Efficacy of ultrasound-guided thoracic paravertebral block at multiple level (T9–T10, T10–T11, T11–T12) was evaluated to manage postoperative analgesia in percutaneous nephrolithotomy surgeries.Methodology: a prospective randomized double-blind study of 60 cases of the American Society of Anesthesiologists I–II patients who underwent percutaneous nephrolithotomy were allocated into group P (test) and group N (control). Immediately after surgery, group P were given ultrasound-guided paravertebral block at T9–T10, T10–T11, T11–T12 on operated side using 5 ml of 0.25 % Levobupivacine at each level, while group N did not receive paravertebral block. The patients were assessed for visual analogue scale (VAS), time for first rescue analgesic, number of rescue analgesics in first 24 hrs postoperatively.Results: VAS pain scale shows significant difference between group P (4.2 + 0.8) and group N (5.3 + 1.1) (p < 0.05) at 30 mins, 2, 4, 8 hrs postoperatively. Total opioid consumption at postoperative 2, 6, and 24 hrs was less in group P than group N (P < 0.05). Number of rescue analgesics in first 24 hrs post-surgery in group P was 3.0 ± 0.4, and 4.0 ± 1.1 in group N with statistical significant difference (p = 0.0001). Total dose of opioid consumption (mg) in group P was 110 ± 40.45, and 155 ± 64.87 mg in group N with statistical significant difference (p = 0.002). The group N cases used more opioid than group P, with lower scores for satisfaction (p < 0.05). Analgesic consumption in postoperative 24 hrs of group P was less than that of group N (P = 0.001). Patient satisfaction score was significantly higher in group P than group N (P = 0.0001) in 24 hrs. No nausea and/or vomiting were noted in both groups.Conclusion: ultrasound-guided thoracic paravertebral block had more analgesic, and reduce the requirement of opioids and maintains stable hemodynamics.