Combined axillary block with "selective" injection of nerves and the axillary catheter: comparison of bupivacaine 0.25% or levobupivacaine 0.25%.

PURPOSE The aim of this study is to apply combination of axillary plexus block with "selective" injection of nerves and continuous catheter technique, and to compare the anesthetic and postoperative analgesic effects of bupivacaine and levobupivacaine. METHODS In 30 scheduled patients for unilateral hand or forearm surgery, an axillary brachial plexus block with "selective" injection of nerves and continuous catheter technique was performed with 40 ml of 2.5 mg/ml of bupivacaine, or levobupivacaine. After catheter placement, motor and sensory block were scored, and the patient was interviwed in the postoperative first 24 hours. The postoperative first analgesic need, total analgesic needs, pain scale and side-effects were registered. RESULTS At the 30th min, complete sensory block was more frequent in the inervation area of the median nerve in the Bupivacaine group than Levobopivacaine group, and in the Bupivacaine group, complete sensory block was more frequent in the inervation area of the median nerve than the other nerves (P < 0.05). Simultaneously, partial motor block of radial nevre was more frequent in the levobupivacaine group (P < 0.05). Tourniquet was well tolerated in all patients with successful block in both groups. Mean duration of analgesia was similar to the bupivacaine and levobupivacaine groups at 14.2 h, and 18.4 h, respectively (NS). CONCLUSION In this tecnique, for median and radial nevre, bupivacained 0.25% produced slightly beter sensory and motor block intensity than levobupivacaine 0.25% in onset of the block. General success in relation to surgery and in the duration of the analgesia was identical in the two groups.