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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.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/comparison-of-effects-of-05-levobupivacaine-with-buprenorphine-and-nalbuphine-in-ultrasound-guided-supraclavicular-brachial-plexus-block-a-randomised-control-trial/453548/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/comparison-of-effects-of-05-levobupivacaine-with-buprenorphine-and-nalbuphine-in-ultrasound-guided-supraclavicular-brachial-plexus-block-a-randomised-control-trial/453548.png","ImageObject",300,407,{"name":92,"@type":93},"Riley","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":39},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What clinical technique and drug combinations were compared in the trial?","Question",{"text":112,"@type":113},"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.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How did buprenorphine affect the onset of blockade compared with nalbuphine and plain levobupivacaine?",{"text":117,"@type":113},"The onset of sensorimotor blockade was notably faster in the levobupivacaine-buprenorphine group than in the nalbuphine or plain levobupivacaine groups.",{"name":119,"@type":110,"acceptedAnswer":120},"What was the overall conclusion about rescue analgesia timing and blockade duration?",{"text":121,"@type":113},"Buprenorphine significantly shortened onset and enhanced blockade duration versus nalbuphine, while both adjuvants delayed the time to request rescue analgesia compared with plain levobupivacaine.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},453548,1790792983,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":39,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},1374391975076,"https://ap-avatar.wpscdn.com/avatar/14000253ca4ec9f6853?x-image-process=image/resize,m_fixed,w_180,h_180&k=1783305029341752051","RESEARCH ARTICLE  \nComparison of effects of 0.5 % levobupivacaine with buprenorphine and nalbuphine in ultrasound-guided supraclavicular brachial plexus block-A Randomised Control Trial  \n[version 1; peer review: 1 approved, 1 approved with reservations]  \nSuvajit Podder 1, Deepali Shetty 1, Shweta Sinha 1, Shwetha Krishna 1, Souvik Chaudhuri2, Mahesh Nayak 1, Aditya Rameshbabu Devalla 1,  \nJesica Maria 1  \n1 Department of Anaesthesiology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India  \n2 Department of Critical Care Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India  \nv1  \nFirst published: 03 Jul 2025, 14:646  \n[https://doi.org/10.12688/f1000research.164457.1](https://doi.org/10.12688/f1000research.164457.1)  \n[Latest published:](Latest published: 18 Dec 2025)[ 18 Dec 2025](Latest published: 18 Dec 2025), 14:646  \n[https://doi.org/10.12688/f1000research.164457.2](https://doi.org/10.12688/f1000research.164457.2)  \nAbstract  \nIntroduction  \nThe 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.  \nMaterials and Methods  \nOur 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  \nOpen Peer Review  \n\n| Approval Status  |  |\n| --- | --- |\n| 1 | 2 |\n| version 2\u003Cbr>(revision)\u003Cbr>18 Dec 2025\u003Cbr>version 1  \u003Cbr>view view\u003Cbr>03 Jul 2025 |  |\n\n1. Vamshidhar Chamala, All India Institute of Medical Sciences, Mangalagiri, India  \n2. Siri Kandavar, KS Hegde Medical Academy, Karnataka, India  \nAny reports and responses or comments on the  \narticle can be found at the end of the article.  \nsensory), sedation score, and time for rescue analgesia.  \nResults  \nThe 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.  \nConclusion  \nBuprenorphine 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.  \nKeywords  \nLevobupivacaine, Nalbuphine, Buprenorphine, Brachial Plexus Block, Orthopedic Procedures  \nThis article is included in the Manipal Academy of Higher Education gateway.  \nCorresponding author: Shwetha Krishna ([shwetharahulnagar@gmail.com](shwetharahulnagar@gmail.com))  \nAuthor 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","cbCaib5j34PPsd6V","https://ap.wps.com/l/cbCaib5j34PPsd6V","pdf",826677,13,"English","# Introduction\n# Materials and Methods\n# Results\n# Conclusion\n# Keywords","[{\"question\":\"What clinical technique and drug combinations were compared in the trial?\",\"answer\":\"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.\"},{\"question\":\"How did buprenorphine affect the onset of blockade compared with nalbuphine and plain levobupivacaine?\",\"answer\":\"The onset of sensorimotor blockade was notably faster in the levobupivacaine-buprenorphine group than in the nalbuphine or plain levobupivacaine groups.\"},{\"question\":\"What was the overall conclusion about rescue analgesia timing and blockade duration?\",\"answer\":\"Buprenorphine significantly shortened onset and enhanced blockade duration versus nalbuphine, while both adjuvants delayed the time to request rescue analgesia compared with plain levobupivacaine.\"}]","Comparison of effects of 0.5 % levobupivacaine with buprenorphine and nalbuphine in ultrasound-guided supraclavicular brachial plexus block - A Randomised Control Trial | PDF",1790739074,33]