Supra clavicular block with buprenorphine for post operative pain relief; comparison between 0.375% bupivacaine and 0.375% bupivacaine with buprenorphine

Background: The use of peripheral nerve blocks for anaesthesia and postoperative analgesia has increased significantly in recent years. Adjuants added to local anaesthetics enhances the quality and duration of anaesthesia and analgesia. With the discovery of peripheral opioid receptors, various opioids have been used as adjuncts. Of all these, the long acting buprenorphine can be used with local anaesthetics to produce post operative analgesia.
Aims: To compare the onset and extent of sensory and motor block. To compare the duration of post operative analgesia between 2 groups.
Methods: A double blinded randomized study was conducted in 60 patients of age 16 to 60 years posted for upperlimb orthopaedic surgeries. Group ‘B’ patients (30) received 30 ml of 0.375% bupivacaine alone whereas group BB patients (30) received 30 ml of 0.375% bupivacaine with 5µg/kg of buprenorphine. Onsent and extent of sensory and motor block were studied. Duration of postoperative analgesia was compared between 2 groups.
Result: Onset of sensory and motor block was quite earlier in Group BB than Group B. Duration of motor block and post operative analgesia was also prolonged in group BB.
Conclusion: Addition of bupreorphine to local anaesthetics quickens the onset of anaesthesia and markedly prolongs the duration of postoperative analgesia.