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Comparison of Bupivacaine and Alkalinized Bupivacaine in Brachial Plexus Anesthesia

Received from the Department of Anesthesia, University of Manitoba, Winnipeg, Manitoba, Canada.

Abstract

To define the effect of alkalinization of bupivacaine 0.5% in subclavian perivascular brachial plexus blockade, the time to onset, time to peak effect, and 6-hour regression of sensory and motor blockade were determined. Sixty physical status ASA I and II patients were randomly allocated to one of two groups and a double-blind design was used: group I (n = 30) received bupivacaine 0.5% (pH, 5.5) 3 mg/kg, while group 11 (n = 30) received alkalinized bupivacaine 0.5% (pH, 7.05–7.15) 3 mg/kg. Onset and regression of sensory blockade were determined by pinprick in the CPT2 skin dermatomes, while motor blockade was assessed using a scheme of proximal to distal muscle group paralysis. Time to onset of sensory blockade (group I, 4.0 ± 1.2 min; group II, 3.6 ± 0.9min) and time to peak sensory effect (group I, 17.7 2 1.8 min; group II, 16.3 ±1.8 min) did not differ significantly between the groups. Similarly, no difference in time to onset of motor blockade (group I, 6.9 ± 1.7 min; group 11, 6.3 ± 2.5 min) or time to peak motor effect (group I, 18.1 2 1.9 min; group 11, 15.1 ± 1.9 min) was observed. Regression of postoperative sensory and motor blockade was similar in both groups. It is concluded that alkalinization of bupivacaine 0.5% solutions does not confer any added clinical advantage in subclavian perivascular brachial plexus blockade when compared with commercially available bupivacaine.

Key Words: ANESTHETIC TECHNIQUES, REGIONAL—brachial plexus block • ANESTHETICS, LOCAL—bupivacaine

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Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999