Supraclavicular Brachial Plexus Block: Comparison of Varying Doses of Nalbuphine Combined with Levobupivacaine: A Prospective, Double-blind, Randomized Trial

Background and Aims The ideal dose of nalbuphine for brachial plexus block (BPB) is a matter of debate. This study was carried out to evaluate 5 mg or 10 mg of nalbuphine added to 0.375% levobupivacaine, with regard to the duration of analgesia. Our study also sought to assess the onset and duration of sensorimotor blockade, hemodynamic effects, sedation, and adverse effects. Materials and Methods One hundred adult patients undergoing upper-limb surgeries under supraclavicular BPB were randomly allocated into two groups. Group LN5 received 29 ml of 0.375% levobupivacaine plus 5 mg of nalbuphine diluted in 1 ml of normal saline. Group LN10 received 29 ml of 0.375% levobupivacaine plus 10 mg of nalbuphine diluted in 1 ml of normal saline. Onset and duration of sensorimotor blockade, hemodynamic variables, duration of analgesia, and adverse effects were recorded. The data were analyzed with Students t-test and Chi-square test. Results Onset of sensory block and motor block was 10.57 ± 3.5 and 17.16 ± 1.3 min, respectively, in Group LN5, while it was 8.64 ± 1.7 and 14.3 ± 1.2 min, respectively, in Group LN10. The duration of analgesia was significantly prolonged in Group LN10 compared to Group LN5 (833.55 ± 141.6 vs. 698.44 ± 138.6 min; P = 0.001). Postoperative visual analog scale value at 24 h was significantly lower in Group LN10 (P < 0.05). Conclusion A higher dose of nalbuphine in BPB hastens the onset, and prolongs the duration of sensorimotor blockade and analgesia, without any significant side effects.