Respiratory effects of low-dose bupivacaine interscalene block

Br J Anaesth. 1999 Feb;82(2):217-20. doi: 10.1093/bja/82.2.217.

Abstract

In this double-blind study, interscalene brachial plexus (ISBP) block was performed in 11 volunteers using 10 ml of either 0.25% (n = 6) or 0.5% (n = 5) bupivacaine with epinephrine 1:200,000. Diaphragmatic excursion, respiratory function and neural function were assessed for 90 min. Our results showed that hemidiaphragmatic excursion declined significantly after block in the 0.5% group and paradoxical movement during inspiration was more common than in the 0.25% group. Forced vital capacity and forced expiratory volume in 1 s declined significantly in the 0.5% group (mean 74.6 (SD 13.0)% and 78.2 (19.9)% of baseline, respectively) but not in the 0.25% group. Sensory anaesthesia in the upper limb was found consistently in both groups, although biceps paralysis occurred earlier after 0.5% bupivacaine. We conclude that ISBP block using 10 ml of 0.25% bupivacaine provided upper limb anaesthesia to pinprick in C5-6 dermatomes with only occasional interference with respiratory function.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Anesthetics, Local / pharmacology*
  • Brachial Plexus
  • Bupivacaine / pharmacology*
  • Diaphragm / drug effects*
  • Diaphragm / physiology
  • Dose-Response Relationship, Drug
  • Double-Blind Method
  • Female
  • Humans
  • Male
  • Movement / drug effects
  • Nerve Block*
  • Respiratory Mechanics / drug effects*
  • Sensation / drug effects

Substances

  • Anesthetics, Local
  • Bupivacaine