A Comparative Clinical Study of Levobupivacaine with Dexmedetomidine v/s Bupivacaine with Dexmedetomidine in Supraclavicular Brachial Plexus Block: A Randomized Control Trial

Abstract

Objectives:  Levobupivacaine is a new local anaesthetic having similar pharmacological profile of Bupivacaine, but with less cardiotoxicity. This study was conducted to assess and compare onset and duration of sensory and motor blockade, with any associated adverse effects, between Levobupivacaine with Dexmedetomidine v/s Bupivacaine with Dexmedetomidine in supraclavicular brachial plexus block. Materials and methods: This was a prospective randomized study, conducted on 100 ASA grade I or II patients, of either sex, aged 18-60 years, scheduled for upper limb surgeries under supraclavicular brachial plexus block, fulfilling inclusion and exclusion criteria. The patients were randomized in two groups of 50 each- in Group LD, Levobupivacaine with Dexmedetomidine while in Group BD, Bupivacaine with Dexmedetomidine was injected as study drug for brachial plexus block. Heart rate (HR), mean arterial pressure (MAP), onset time for complete sensory and motor blockade, along with duration of sensory and motor blockade were studied. Results: It was observed that 1. Hemodynamic parameters remain comparable in both groups throughout the surgery.2. Average time of onset of sensory and motor blockade differ significantly in both the groups (earlier in group of Bupivacaine with Dexmedetomidine) but difference in duration of sensory and motor blockade was not statistically significant in both the groups.Conclusion: Onset of sensory and motor blockade was significantly earlier in Bupivacaine with Dexmedetomidine, compared to Levobupivacaine with Dexmedetomidine; but duration of sensory and motor blockade of two groups was approximately similar. In this study we found that Levobupivacaine was an appropriate drug for brachial plexus block. Its less toxic potential than Bupivacaine was also a positive factor, thus Levobupivacaine increases the safety margin in regional anaesthesia.