A retrospective examination of the upper extremity blocks in approach supraclavicular

A retrospective study between 2009 June and 2010 June, emergency or elective, one-sided hand, forearm or arm surgery to be applied in ASA I-II group, 50 patients were enrolled between the ages of 18-65.The study subjects were divided randomly into 2 groups of 25 persons. Group B (bupivacaine group), 40ml (0.5%; 5mg/ml), bupivacaine, Group L (levobupivacaine group) 40 ml (0.5%; 5mg/ml) levobupivacaine was performed.Patients to be admitted to the supine position and head turned away from the location of the block. Immediately applied to the upper part of the center point of klavikulasının extremity peripheral block, subclavian artery, external jugular vein and sternocleidomastoid muscle to the outer part of the lateral head was found by determining the block point. The deltoid muscle in the arm on the block will be pasted in a two ECG electrodes.Skin cleansing with povidone iodine in the region has been applied to the block, 1-2 mL of 2% lidocaine (epinephrine) was performed with local anesthesia. The nerve stimulator initially 1.0 mA, 2 Hz, 0.1 ms, set the parameters. Initiative from the marked, from the stimulator needle was performed under local anesthesia caudal, medial and slightly back slightly slowly advanced to the right. Appropriate muscle movements of the nerves was observed, medications (bupivacaine and levobupivacaine) 10 or 15 each ml, 5 ml each were given an equal proportion to the nerves were aspirated.Application has been made a 5-minute intervals of 5 minutes, then the operation zone "¬ pin prick test was to be controlled.Anaesthesia settlement period "pin-prick" and the touch test and the modified Bromage scale motor block quality were evaluated.Motor block onset time, local anesthetic injection of the engine block (shoulder kaldıramama) the formation period, the local anesthetic injection, sensory block onset time of intervention in "pin-prick test were recorded as the time off until the pain sensation. "Pin-prick" test pozitifleşince surgery was allowed in the surgery.Patients with duration of sensory block, onset of sensory block was recorded as the time until the pain sensation. The duration of the engine block, engine block completely the beginning of the movement of the arm were recorded as the time to win again.According to these periods, patients 4, 8 and 24 hours visits were made.Also during the operation of additional analgesic medication was performed in cases of pain or stress. Fentanyl was given for this purpose, the total doses given were recorded.All the complaints of the patients during and after the block, the block-related complications and side effects of drugs used were recorded for each patient individually.The postoperative pain "verbal rating scale (VRS), with patient satisfaction is" not satisfied, less happy and satisfied "were evaluated as a postoperative 24.saatinde. VRS 2 when the first analgesic (contromal iv) was given to the service after complaints of doctors and the patient was given a personal decision. Patients wards 4-8. 24.saatinde were visited during the block and return periods, pain complaints and their total recorded in all patients.Supplementary statistics, frequency tables, intra-group and intergroup differences sınanmasında SPSS 15 statistical software package used. Age, height, kg, adequate sensory block access time, total development time of the engine block, motor block, duration, time to first analgesic requirement, postoperative 24-hour analgesic consumption, duration of need for intraoperative additional analgesia, surgical comfort, patient satisfaction comparisons between the groups in mean Student's t test was used to test and rate. Chi-square test for categorical variables or Fisher's exact test was used. P ? 0.05 considered statistically significant difference will be whenIn our study, demographic characteristics (age, weight, height, sex), ASA values, areas of operation, intraoperative and postoperative opioid requirements were no significant differences between groups in terms of satisfaction.When sensory and motor block onset times, bupivacaine, levobupivacaine group was significantly less than the block formed by the group found. Total duration of sensory and motor block, were similar in both groups.Postoperative values of VRS in the bupivacaine group had values greater than in the levobupivacaine group. In both groups, postoperative time to first pain and analgesics did not differ significantly between the number of patients.Complications in Group L than in group B were significantly greater. Complications occurred in 4 patients in Group B, Group L also 3hastada complications were observed. Horner's syndrome in 2 patients in group B (pitosis, myosis), 2 had prolonged blockade (24 hours) was ... Horner's syndrome in 2 patients in Group L, and 1 patient had prolonged blockade.There were no permanent neurological impairment in patients who developed complications in the follow up.In general, our study, the duration of sensory and motor block, but also adequate in both groups found that the duration of postoperative analgesia.In conclusion, levobupivacaine and bupivacaine in brachial plexus block is used for providing the motor and sensory block of 0.5% believe that the concentration is sufficient. Neurotoxic side effects of bupivacaine (Horner's syndrome, prolonged blockade, etc.) than levobupivacaine was evident. In addition, the potential cardiotoxic side effects of bupivacaine Given concluded that levobupivacaine is more secure.