[Axillary plexus block by simultaneous blockade of several nerves. II. Evaluation of lidocaine-bupivacaine combination]

Ann Fr Anesth Reanim. 1993;12(3):233-6. doi: 10.1016/s0750-7658(05)80646-x.
[Article in French]

Abstract

A mixture of carbonated lignocaine and bupivacaine for axillary blocks was assessed prospectively in a randomized double-blind study including 60 patients scheduled for upper limb surgery. A peripheral nerve stimulator was used to carry out the axillary block with a multiple injection technique. The musculocutaneous, radial, median and ulnar nerves were routinely stimulated. Four criteria were monitored: quality of sensory blockade, degree of motor blockade, time of onset and duration of anaesthesia. The patients were randomly assigned to three groups (n = 20 each). Patients received 25 ml per m2 of body surface area of either carbonated 1% lignocaine (group 1) or 0.25% bupivacaine (group 2) or a 1 to 1 mixture of both (group 3). Adrenaline (1 in 400,000) was added to half the anaesthetic solutions used in each group. The onset of anaesthesia was faster with the mixture (15 +/- 9 min) than will bupivacaine alone (23 +/- 14 min) (p < 0.02). It lasted longer in the mixture group (264 +/- 111 min) than in the lignocaine group (193 +/- 83 min). The longest duration was in the bupivacaine group (476 +/- 276 min) (p < 0.03). Adrenaline only affected significantly the duration of anaesthesia in the lignocaine group (252 min vs 135 min with and without adrenaline, respectively) (p < 0.03). In axillary blocks, the mixture of carbonated lignocaine and bupivacaine has a faster onset of action than bupivacaine alone, and a longer duration of action than lignocaine alone. Both agents provided a quality of sensory and motor blockade similar to that obtained with the mixture.

Publication types

  • Clinical Trial
  • Comparative Study
  • English Abstract
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Axilla
  • Brachial Plexus*
  • Bupivacaine / administration & dosage*
  • Bupivacaine / pharmacology
  • Double-Blind Method
  • Drug Combinations
  • Drug Evaluation
  • Female
  • Humans
  • Lidocaine / administration & dosage*
  • Lidocaine / pharmacology
  • Male
  • Middle Aged
  • Nerve Block / methods*

Substances

  • Drug Combinations
  • Lidocaine
  • Bupivacaine