Effect of buprenorphine as an adjunct with plain local anesthetic solution in supraclavicular brachial plexus block on quality and duration of postoperative analgesia

BACKGROUND AND AIMS: Supraclavicular brachial plexus block is ideal for upper limb surgical procedures. Buprenorphine, an agonist antagonist opioid has been used as an adjunct to prolong analgesia. We aimed to evaluate the quality and duration of postoperative analgesia by addition of buprenorphine to local anesthetic solution. MATERIAL AND METHODS: A prospective, randomized, double-blind control study was conducted on 50 healthy patients of ASA Grade I/II of age group 20-70 years scheduled for orthopedic and reconstructive surgery of upper limb under supraclavicular brachial plexus block. Patients were allocated into two groups, 25 in each group viz.: Group B (buprenorphine group) received 20 ml 0.5% bupivacaine + 15 ml 2% lignocaine with adrenaline (1:200,000) + 4 ml normal saline + 1500 units hyaluronidase + 3 μg/kg buprenorphine diluted to 1 ml normal saline. Group C (control group) received 20 ml 0.5% bupivacaine + 15 ml 2% lignocaine with adrenaline (1:200,000) + 4 ml normal saline + 1500 units hyaluronidase + 1 ml normal saline. The parameters observed were onset and duration of sensory and motor block, quality and duration of analgesia and side-effects. RESULTS: The mean duration of postoperative analgesia was significantly longer in Group B (16.04 ± 3.19 h) than in Group C (6.20 ± 0.74 h). There was no difference between two groups on mean onset of sensory block. The mean duration motor block was significantly longer in Group B (4.93 ± 0.94 h) than in Group C (2.25 ± 0.62 h) [P < 0.05]. The mean duration of sensory block was also significantly longer in Group B (5.71 ± 0.94 h) than in Group C (4.94 ± 0.70 h) with P < 0.05. CONCLUSION: Addition of 3 μg/kg buprenorphine to 0.5% bupivacaine for supraclavicular brachial plexus block prolonged duration of postoperative analgesia and sensory blockade without an increase in side effects.