Effect of alkalinization of bupivacaine on axillary brachial plexus blockade

ABSTRACT

40 adult patients of both sexes undergoing elective forearm and h and surgery were subjected to this study. An informed consent was taken from every patient. No premedication was given and a patient iv. line was prepared. Brachial plexus block was done as usual but full abduction of humerus was avoided as it impedes arterial pulsation and hinders proximal and circumferential spread of local anesthetic. Also, a plastic cannula was used for local anesthetic administration into neurovascular sheath. The proximal and of this cannula was advanced centrally for at least 3 cm to ensure that the injection is made above the point where the musculocutaneous nerve leaves the sheath. In a double blind manner either bupivacaine adrenaline in freshly prepared alkalinized bupivacaine adrenaline was administered in each half of patients. The dose of bupivacaine given was 2.5 mg/kg [i.e. 0.5 ml/kg]. After local anesthetic administration, sensory and motor assessments were done before, during and after operation. Also, if signs of systemic toxicity had occurred, they must be recorded and probably treated. All patients were also examined daily for 10 days postoperatively for detection of sign of nerve lesion. From this study, it was found that alkalinization of bupivacaine is a simple, safe and effective method for reduction of block latency, increasing the incidence of adequate analgesia and prolongation of postoperative useful analgesia of axillary brachial plexus blockage