Comparative clinical evaluation of buprenorphine versus morphine as adjuvant to bupivacaine in supraclavicular brachial plexus block for upper limb surgery

Background: The supraclavicular brachial plexus block with local anesthetics is one of the most commonly used regional nerve block technique for upper limb surgeries being to their high success rate and ability to provide prolonged postoperative pain relief. Opioid has been used as an adjuvant to prolong analgesia with local anesthetic. Aim: Aim of study to evaluate the quality and duration of postoperative analgesia by adding buprenorphine and morphine to local anesthetic solution. Method: A prospective, observational study was conducted on 60 healthy patients of ASA grade I and II of age group 18-45 years scheduled for upper limb surgery under supraclavicular brachical plexus block. Patients were allocated into two groups, 30 in each group. Group BB (buprenorphine group) received: 0.5% Bupivacaine 20 ml + 3μg/kg Buprenorphine + 10ml normal Saline. Group BM (morphine group) recieved: 0.5% Bupivacaine 20ml + 75 μg/kg Morphine + 10ml normal Saline. The parameters observed were onset and duration of sensory and motor block, quality and duration of analgesia and side-effects. Result: The mean duration of postoperative analgesia was significantly longer in group BB (20.6±2.11hrs) than in group BM (13.03±1.32hrs). There was no difference between two groups on mean onset of sensory and motor block. The mean duration of sensory block was significantly longer in group BB (539.67±13.22min) than in group BM (312±9.38min) with p<0.05. The mean duration of motor block was insignificant The mean duration of motor block was also significantly longer in group BB (310.67±15.42min) than in group BM (178±9.79min) with p<0.05. Conclusion: Addition of 3μg/kg buprenorphine to 0.5% buprenorphine for supraclavicular brachical plexus block prolonged duration of postoperative analgesia and sensory blockade than morphine without an increase in side effects