European Journal of Molecular & Clinical Medicine

Abstract

Background: Supraclavicular block is commonly used for surgical procedures on the elbow, forearm, and hand. A variety of opioid medications are used as adjuvants to provide postoperative analgesia via brachial plexus block. We in the current study evaluated the efficacy of Buprenorphine versus Butorphanol along with local anesthetics for postoperative analgesia.
Methods: N=50 cases aged from 18 to 50 years with an ASA grade of I or II undergoing orthopedic upper limb procedures by supraclavicular brachial plexus block. Group, I (Buprenorphine 100 µg) and group II (Butorphanol 1 mg) were added to the local anesthetic mixture via injection. In both, groups the onset of sensory block, motor block, and the extent of blockage were investigated, and the occurrence of any complications was noted. All patients were monitored for analgesia hourly until the VAS pain score indicated that analgesia was required post-operatively.
Results: The onset of sensory blockade was 4.85 ± 1.1 minutes in group II and 3.51 ± 0.9 minutes. Similarly, the onset of motor block was 8.89 ± 3.2 minutes in group I and 5.85 ± 2.23 in group II. The onset of the complete block was at 16.59 ± 4.51 minutes in group I and 13.29 ± 2.11 minutes in group II. group II had the mean VAS scores higher which indicates moderate pain and rescue analgesia was required in group II. In group I the mean VAS scores was less than 4 and the requirement of rescue analgesia was not necessary. The mean duration of analgesia was also greater in group I was 19.50 ± 5.5 hours compared to group II was 16.33 ± 6.7 hours.
Conclusions: The duration of postoperative analgesia was greater in the buprenorphine group as compared to the butorphanol group.  The mean VAS scores were higher in the butorphanol group at the end of 6 hours and the requirement for rescue analgesia was higher in the group. Therefore, buprenorphine appears to have higher efficacy and longer duration of action as compared to butorphanol for infusion along with local anesthetics for supraclavicular blocks.