Abstract
ONSET TIME OF LIGNOCAINE ALONE IS LESS THAN OF MIXED BUPIVACAINE WITH LIGNOCAINE DURING ULTRASOUND GUIDED BRACHIAL PLEXUS BLOCKADE

Mohammad J. Ismail*, Sami A. Alrwashdeh, Nizar Al-baryhie, Laith Altarawni and Mohammad A. Adaileh

ABSTRACT

Background: Reduced dosage of local anesthetics can be administered during regional blockades when neural components via ultrasound are clear. The decreased dosage is not unambiguous. Goal: To determine the onset time of pain relief action of local anesthetics alone or in mixture solutions administered for brachial plexus blockade. Methods: Our prospective, double blind and randomized investigation included 113 subjects, aged 31-68 yrs., of both sexes, classed I by the American Society of Anesthesiologists and registered for upper limb operations under brachial plexus blockade with ultrasound guided using lignocaine 1% mixed with bupivacaine 0.5% (1:1) (Group LB, GI, n=22), bupivacaine alone 0.5%[2:1] (Group BS, GII, n=18), lignocaine alone 1%[2:1] (Group LS, GIII, n=18) and bupivacaine 0.5% mixed with lignocaine 1% (2:1) (Group BL, GIV, n=55), at Queen Alia military hospital and Royal rehabilitation center, Amman, JORDAN, during the period May 2020-May 2021. Every subject in all groups received 0.5 ml/kg. Median Onset time for sensory or motor blockade was defined as the period between the finish of overall local anesthetic administration and full sensory or motor blockade. Data were recorded before surgery and after surgery at 6 and 24hrs. intervals using verbal analogue scale for pain severity. Kruskal-Wallis with Mann–Whitney U tests were used for ordinal data. The Chi-square test was used for the categorical parameters between the groups. Results: The onset time was remarkably less in the lignocaine group (LS, GIII, 10.0 min.) than in the other groups (LB, GI, 13.0 min.; BS, GII, 14.0 min.; BL, GIV, 13.0 min., P < 0.05). No discrepancies were recorded in the onset times between LB(GI), BS(GII) and BL(GIV) groups (P > 0.05). Statistical discrepancies were recorded in the period of pain relief of local anesthetics between LB(GI) (340.0 min.), BS(GII) (491.0 min.), LS(GIII) (123.0 min.) and BL(GIV) (400.0 min., P < 0.05). The sensory onset time was remarkably less (10.0 min.) in the lignocaine group (LS, GIII) in comparison to that in the LB(GI), BS(GII) and BL(GVI) groups. The full motor onset time was less (14.0 min.) in the bupivacaine group (BS) in comparison to that in the LB (16.0 min.), LS (17.0 min.) and BL (15.0 min.) groups. Conclusion: Lignocaine has not reduced the onset time, but remarkably reduced the period of action of bupivacaine when mixed. Bupivacaine with no lignocaine possess the highest period of action of pain relief after surgery.

Keywords: Brachial plexus blockade: lignocaine, bupivacaine; Pain relief: onset, period; Ultrasound.


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