Comparison of two different volumes of 0.5% levobupivacaine for ultrasound-guided costoclavicular brachial plexus block in forearm surgeries: A randomized double-blind tertiary care hospital-based study

Background: The costoclavicular approach to brachial plexus block provides a dense blockade similar to the supraclavicular approach and requires a lesser volume of local anesthetic. Levobupivacaine is a safer alternative to bupivacaine with similar pharmacological properties. In this study, we compared two different volumes of 0.5% levobupivacaine, used for costoclavicular brachial plexus block, that is 15ml and 20ml. Materials and Methods: The study included 59 patients with American Society of Anesthesiologists (ASA) Classes I–III of either sex, aged 18–65 years. Patients were randomly allocated into two groups. Group levobupivacaine 15 (LB15) received 15mL of 0.5% levobupivacaine, and Group levobupivacaine 20 (LB20) received 20 ml of 0.5% levobupivacaine, with1μg/kg dexmedetomidine added as an adjuvant in both groups. Block characteristics, including time to onset and duration of block, time to demand of first rescue analgesic, quality of block, and perioperative hemodynamic variability, were compared between groups. Results: No significant difference was observed in block onset or duration (sensory and motor) between the two groups (p>0.05). Differences in the mean time to demand for first rescue analgesia were also statistically insignificant between the two groups (p=0.353). Conclusion: A 15-mL volume of 0.5% levobupivacaine was equally as effective as a 20-mL volume in terms of time to onset and duration of block, time to demand of first rescue analgesic, block quality, and perioperative hemodynamic variability in costoclavicular brachial plexus block for forearm surgeries.