Buprenorphine with Local Anaesthetic Combination in Supraclavicular Brachial Plexus Block Produced Prolonged Post-operative Analgesia Compared to Butorphanol with Local Anaesthetic: A Prospective, Randomized, Comparative Study

Background: Supraclavicular approach for brachial plexus block offers an alternative anesthesia for upper extremity surgery.Addition of opioid agents in local anesthetic solutions for prolongation of analgesia through brachial plexus block has beenvery effective in controlling post-operative pain. The time to request for the 1st dose of rescue analgesia can be prolonged byadding buprenorphine or butorphanol in local anesthetic solutions.Methodology: After institutional ethical committee approval, 60 American Society of Anesthesiologists I/II patients wererandomized for this study. They belong to either gender, aged between 18 and 55 years of age. Patients who required brachialplexus block through supraclavicular approach were included and the study drugs were administered according to groupallocation into Group I and Group II. Sensory and motor block characteristics were monitored and recorded in all patients,complications as well. Hemodynamic monitoring was done every 5 min interval in the intraoperative period and every 15 minintervals in the post-operative period. Patients were administered rescue analgesia postoperatively when visual analog scale(VAS) scores were ≥4. Data were analyzed statistically.Results: Onset time to sensory block was 3.1 (1.1) min in Group I and 4.9 (1) min in Group II, and there was statistically significantdifference between groups (P < 0.0001). Onset time to motor block was 5.4 (1.3) min in Group I and 9.3 (1.5) min in Group II,and the difference between groups was found to be significant statistically (P < 0.0001). The time to 1st request of analgesiawas found to be statistically significantly between I and II groups (354.8 [55.6] vs. 448.3 [34.4] min, P < 0.0001), respectively.Conclusion: Both buprenorphine and butorphanol produced effective analgesia in combination with local anesthetics withoutsignificant side effects, but buprenorphine produced prolonged analgesia when compared to butorphanol.