Journal of AdvancedMedical and Dental Sciences Research

Aim: To compare the quality of analgesia and incidence of adverse effects using two different volumes of 0.5% levobupivacaine for clavicular surgeries by ultrasound guided combined interscalene and superficial cervical plexus block. Material and Methods: 120 patients undergoing clavicular surgery were randomized to receive ultrasound guided interscalene block of either 10 ml(group L)or 20 ml(Group H) of 0.5% levobupivacaine and 5 ml of 0.5% levobupivacaine for superficial cervical plexus block. Both the groups were assessed for quality of intraoperative and postoperative analgesia by sensory,motor block. Hemidiaphragmatic paresis was assessed by ultrasound guided diaphragmatic movement. Results: Adequacy of intraoperative anesthesia and analgesia was comparable in both the groups. Phrenic nerve palsy was present in 12 patients of group H whereas none of the patients of group L developed phrenic nerve palsy. There was no requirement of supplementation of analgesics in both the groups intraoperatively. The duration of postoperative analgesia was 5.68 ± 0.2 hours in group L and 5.4 ± 0.2 hours in group H. Conclusion: Comparable quality of intraoperative and postoperative analgesia and reduced incidence of hemidiaphragmatic paresis can be obtained with 10 ml compared to 20 ml of 0.5% levobupivacaine.