Comparison of effects of 0.5 % levobupivacaine with buprenorphine and nalbuphine in ultrasound-guided supraclavicular brachial plexus block - A Randomised Control Trial

Sep 30, 2026

Uploaded by Riley

Regional anesthesia supports safe, cost-effective perioperative care and sustained postoperative analgesia, with supraclavicular brachial plexus block (SCBB) offering reliable blockade quality and faster onset. This randomized prospective double-blinded study evaluated 0.5% levobupivacaine plain versus levobupivacaine combined with buprenorphine or nalbuphine as adjuvants in 60 elective upper-limb orthopedic surgery patients. Outcomes included onset and duration of motor and sensory blockade, sedation score, and time to rescue analgesia.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages13

Reading Time33 min

AccessFree to download

Introduction

Materials and Methods

Results

Conclusion

Keywords

RESEARCH ARTICLE Comparison of effects of 0.5 % levobupivacaine with buprenorphine and nalbuphine in ultrasound-guided supraclavicular brachial plexus block-A Randomised Control Trial [version 1; peer review: 1 approved, 1 approved with reservations] Suvajit Podder 1, Deepali Shetty 1, Shweta Sinha 1, Shwetha Krishna 1, Souvik Chaudhuri2, Mahesh Nayak 1, Aditya Rameshbabu Devalla 1, Jesica Maria 1 1 Department of Anaesthesiology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India 2 Department of Critical Care Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India v1 First published: 03 Jul 2025, 14:646 [https://doi.org/10.12688/f1000research.164457.1](https://doi.org/10.12688/f1000research.164457.1) [Latest published:](Latest published: 18 Dec 2025)[ 18 Dec 2025](Latest published: 18 Dec 2025), 14:646 [https://doi.org/10.12688/f1000research.164457.2](https://doi.org/10.12688/f1000research.164457.2) Abstract Introduction The brachial plexus block is one of the most commonly used anaesthesia techniques for upper limb surgeries. The supraclavicular brachial plexus block (SCBB) has been a frequently performed technique because it provides excellent quality of blockade, faster onset, and dense blockade. Different adjuvants and local anaesthetics are used to improve the onset and quality of the blockade. In our study, the local anaesthetic used was 0.5% levobupivacaine, and the adjuvants used were buprenorphine and nalbuphine. Materials and Methods Our study, a randomised, prospective double-blinded investigation, was conducted on 60 patients scheduled for elective upper limb orthopaedic surgeries. We performed the Supraclavicular brachial plexus block with 25 ml of 0.5% levobupivacaine plain (Group L) or with buprenorphine (Group LB) or with nalbuphine (Group LN) as adjuvants. We recorded the onset, duration of blockade (motor and Open Peer Review | Approval Status | | | --- | --- | | 1 | 2 | | version 2
(revision)
18 Dec 2025
version 1
view view
03 Jul 2025 | | 1. Vamshidhar Chamala, All India Institute of Medical Sciences, Mangalagiri, India 2. Siri Kandavar, KS Hegde Medical Academy, Karnataka, India Any reports and responses or comments on the article can be found at the end of the article. sensory), sedation score, and time for rescue analgesia. Results The onset of sensorimotor blockade was notably faster in Group LB than in Group LN or Group L. The sensorimotor blockade duration was significantly prolonged in Group LB compared to LN and L. Group LB also had a delayed time after 12 hrs for rescue analgesia compared to the other two groups. Conclusion Buprenorphine as an adjuvant to 0.5% levobupivacaine in ultrasoundguided supraclavicular brachial plexus block significantly shortens the onset of sensorimotor blockade and enhances the duration of blockade when compared to nalbuphine. Both the adjuvants delayed the time for request of rescue analgesia compared to plain levobupivacaine. Keywords Levobupivacaine, Nalbuphine, Buprenorphine, Brachial Plexus Block, Orthopedic Procedures This article is included in the Manipal Academy of Higher Education gateway. Corresponding author: Shwetha Krishna ([shwetharahulnagar@gmail.com](shwetharahulnagar@gmail.com)) Author roles: Podder S: Conceptualization, Investigation, Methodology, Project Administration, Supervision, Validation, Writing – Review & Editing; Shetty D: Data Curation, Investigation, Project Administration, Resources, Software, Writing – Review & Editing; Sinha S: Data Curation, Investigation, Resources, Supervision, Visualization, Writing – Review & Editing; Krishna S: Conceptualization, Formal Analysis, Investigation, Resources, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing; Chaudhuri S: Data Curation, Investigation, Project Administration, R

FAQs

What clinical technique and drug combinations were compared in the trial?

The study compared ultrasound-guided supraclavicular brachial plexus block using 0.5% levobupivacaine plain versus 0.5% levobupivacaine with buprenorphine or with nalbuphine as adjuvants.

How did buprenorphine affect the onset of blockade compared with nalbuphine and plain levobupivacaine?

The onset of sensorimotor blockade was notably faster in the levobupivacaine-buprenorphine group than in the nalbuphine or plain levobupivacaine groups.

What was the overall conclusion about rescue analgesia timing and blockade duration?

Buprenorphine significantly shortened onset and enhanced blockade duration versus nalbuphine, while both adjuvants delayed the time to request rescue analgesia compared with plain levobupivacaine.

Sep 30, 2026

Uploaded by Riley