STUDY & EVALUATE THE COMPARISON OF PLAIN LIGNOCAINE AND LIGNACAINE WITH SODIUM BICARBONATE EFFECTS IN SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK

Abstract

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.

Evaluation of Addition of Sodium Bicarbonate to Dexamethasone and Ropivacaine in Supraclavicular Brachial Plexus Block for Upper Limb Orthopedic Procedures

“…Devaram et al [ 15 ] studied the effect of addition of sodium bicarbonate to lignocaine and found it to provide a quicker onset as well as prolong the duration of action of the local anaesthetic. Manjunath et al [ 16 ] added sodium bicarbonate to a mixture of lignocaine and bupivacaine and observed results similar to Devaram et al However, Ninan and Kurien[ 17 ] compared addition of sodium bicarbonate and potassium chloride to bupivacaine and concluded that addition of potassium chloride had significant clinical advantage over alkalinised bupivacaine.…”

“…While workers such as Kumar et al [ 3 ] and Biradar et al [ 4 ] studied the addition of dexamethasone to ropivacaine and lignocaine, respectively. Contreras-Domínguez et al [ 5 ] and Devaram et al [ 6 ] evaluated the addition of sodium bicarbonate to mepivacaine and lignocaine, respectively. Hence, both dexamethasone and sodium bicarbonate have been studied individually as adjuvants in peripheral nerve blocks with favorable results.…”