COMPARISON OF THE PAIN RELIEF EFFECT IN PAIN RELIEF IN AND AFTER HAND SURGERY IN CHILDREN OF AXILLARY LINE BRAINSYNCING WITH DIFFERENT CONCENTRATIONS OF LEVOBUPIVACAINE
Main Article Content
Abstract
Objective: To compare the efficacy of pain reduction during and after forearm and hand surgery in children using ultrasound-guided axillary brachial plexus block with Levobupivacaine 0.2% versus Levobupivacaine 0.25%.
Subjects and methods: This study was conducted on 60 patients (aged 3-16 years) receiving axillary brachial plexus block at the Department of Anesthesiology and Intensive Care, National Children’s Hospital. Patients were randomly assigned to 2 groups: group 0.2 which used Levobupivacaine 0,2%, and group 0.25 which used Levobupivacaine 0,25%. Both groups used a volume of 0.5 ml/kg, maximum 20 ml.
Results: The two groups were comparable regarding general characteristics: mean age 7.25 ± 3.34 years; weight 26.71 ± 10.39 kg; height 120.07 ± 17.93 cm; surgical duration 61.45 ± 22.19 minutes (p > 0.05). The efficacy of intraoperative anesthesia was good in both groups (100%). The duration of sensory and motor block for group 0.2 was 255.17 ± 43.10 minutes and 214.40 ± 38.46 minutes, respectively, and for group 0.25 was 356.97 ± 46.35 minutes and 311.53 ± 43.94 minutes (p < 0.001). The duration of analgesia for group 0.2 and group 0.25 was 367.87 ± 44.25 minutes and 414.30 ± 50.01 minutes, respectively (p < 0.05). The number of times additional analgesics were administered within 24 hours post-surgery was comparable between the two groups (p > 0.05). 2/60 cases reported pain at the injection site, 1/60 cases reported nausea. No excessive sedation or severe adverse effects were recorded.
Conclusion: Both groups achieved good intraoperative anesthetic efficacy. Group 0.2 had an earlier recovery time for sensory and motor function (p < 0.001), and a shorter postoperative analgesia time (approximately 47 minutes less on average) compared to group 0.25 (p < 0.05). There was no difference in the number of times rescue analgesics were administered between the two groups over 24 hours after surgery (p > 0.05).
Article Details
Keywords
Brachial plexus block, regional anesthesia, axillary approach, children, drug concentration, pain management.
References
G. The efficacy of pediatric ultrasound guided brachial plexus block anesthesia and determination of optimal anesthetic drug dosage. Minerva Pediatr (Torino), 2023, 75 (2): 171-175. https://doi.org/10.23736/s2724-5276.16.04716-2.
[2] Ozen T, Tastan S, Akdogan A, et al. Comparison of Bupivacaine and Levobupivacaine in continuous axillary brachial plexus block. Turkish Journal of Anaesthesiology and Reanimation, 2012, 40 (3):141-145.
[3] Mai Hữu Hưng. So sánh tác dụng của gây tê đám rối thần kinh cánh tay đường nách bằng Levobupivacaine với Ropivacaine dưới hướng dẫn siêu âm trong phẫu thuật hội chứng ống cổ tay. Luận văn bác sĩ chuyên khoa cấp 2, Trường Đại học Y Hà Nội, 2020.
[4] Klein S.M, Greengrass R.A, Steele S.M et al. A comparison of 0.5% Bupivacaine, 0.5% Ropivacaine,and 0.75% Ropivacaine for interscalene brachial plexus block. Anesth Analg, 1998, 87 (6): 1316-9. https://doi.org/10.1097/00000539-199812000-00019.
[5] Đỗ Thị Hải. Đánh giá tác dụng gây tê đám rối thần
N.N. Que et al. / Vietnam Journal of Community Medicine, Vol. 67, No. 1, 61-6666 www.tapchiyhcd.vn kinh cánh tay đường trên xương đòn dưới hướng dẫn của siêu âm bằng Levobupivacaine 0,25% trong phẫu thuật chi trên ở trẻ em. Luận văn thạc sỹ y học, Trường đại học Y Hà Nội, 2016;
[6] Vaghari B, Baratta J, Gandhi K. Pain assessment in
the PACU. In: Dolin S.J, Padfield N, eds. Post-Anesthesia Care: Symptoms, diagnosis, and management. Oxford University Press, 2016: 272.https://doi.org/10.2147/JPR.S142889.
[7] Nguyễn Đắc Thanh. So sánh hiệu quả vô cảm,giảm đau sau mổ của Levobupivacaine với Ropivacaine trong phong bế liên tục đám rối thần kinh cánh tay đường nách có siêu âm hướng dẫn. Luận văn thạc sĩ y học, Trường đại học Y Hà Nội, 2016.
[8] Iyer L.S, Bhat S.S, Nethra H.N, Vijayakumar H.N, Sudheesh K, Ramachandriah. A Comparative Study of Effect of 0.25% Levobupivacaine with Dexmedetomidine versus 0.25% Levobupivacaine in ultrasound-guided supraclavicular brachial plexus block. Anesthesia Essays and Researches,
2021, 15 (4): 443-447. https://doi.org/10.4103/aer.aer_145_21.
[9] Trần Duy Thịnh, Ngô Dũng, Trần Việt Phương. Nghiên cứu hiệu quả của gây tê đám rối thần kinh cánh tay đường trên đòn bằng Levobupivacaine 0,5% so với 0,375% dưới hướng dẫn siêu âm trong phẫu thuật chi trên. Tạp chí Y học lâm sàng, Bệnhviện Trung ương Huế, 2023, 87: 5-10. https://doi.
org/10.38103/jcmhch.87.17.