Retrospective Analysis of 0.25% Bupivacaine for Ultrasound-Guided Infraclavicular and Supraclavicular Nerve Blocks in an Ambulatory Surgery Center

Benjamin Rachman; Alec Bigness; Rahul Mhaskar; Nathan Rachman

doi:10.7759/cureus.27391

Retrospective Analysis of 0.25% Bupivacaine for Ultrasound-Guided Infraclavicular and Supraclavicular Nerve Blocks in an Ambulatory Surgery Center

Cureus. 2022 Jul 28;14(7):e27391. doi: 10.7759/cureus.27391. eCollection 2022 Jul.

Authors

Benjamin Rachman¹, Alec Bigness¹, Rahul Mhaskar², Nathan Rachman^{3

4}

Affiliations

¹ Orthopedic Surgery, University of South Florida Morsani College of Medicine, Tampa, USA.
² Internal Medicine, University of South Florida Morsani College of Medicine, Tampa, USA.
³ Anesthesiology, Florida State University College of Medicine, Daytona Beach, USA.
⁴ Anesthesiology, Halifax Health Medical Center, Daytona Beach, USA.

Abstract

Bupivacaine hydrochloride 0.5% (5 mg/mL) is commonly utilized for analgesia in brachial plexus blocks. We suggest that ultrasound-guided 0.25% (2.5 mg/mL) bupivacaine can be utilized for effective postoperative analgesia to reduce the effective dose. A total of 126 patients underwent ultrasound-guided brachial plexus blocks with 0.25% bupivacaine. The mean duration of analgesia was 21.95 (σ = 3.93) hours with no complications. Patients that received an infraclavicular block (22.56 σ = 4.02) had a significant increase in analgesia compared to supraclavicular blocks (21.09, σ = 3.69) (p = 0.04). These results suggest that further research is warranted for ultrasound-guided 0.25% bupivacaine in brachial plexus nerve blocks.

Keywords: 0.25% bupivacaine; infraclavicular brachial plexus block; supraclavicular brachial plexus block; ultrasound guided blocks and vascular access; ultrasound guided regional anesthesia.