OBJECTIVE To compare the duration of sensory blockade of butorphanol-levobupivacaine mixture with levobupivacaine in supraclavicular brachial plexus block for upper limb orthopaedic surgeries. SETTING AND DESIGN Prospective randomized double-blind case control comparative study conducted at tertiary level teaching hospital. MATERIALS AND METHODS 50 patients aged between 20-70 yrs. of ASA grade 1 and 2 undergoing elective upper limb orthopaedic surgeries were randomly allocated into two groups

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... 25 patients each. Patient in Group A and Group B. In Group A (n = 25), 24 mL of 0.5% levobupivacaine + 1 mL (1 mg) Butorphanol; and in Group B (n = 25), 24 mL of 0.5% levobupivacaine + 1 mL normal saline were given for supraclavicular brachial plexus block using the peripheral nerve stimulator. Onset and duration of sensory and motor blocks were assessed along with the duration of analgesia, sedation and adverse effects if any. Haemodynamic parameters like Heart Rate (HR), Systolic Arterial Blood Pressure (SBP) and Diastolic Arterial Blood Pressure (DBP) were also monitored. RESULTS Demographic data and surgical characteristics were comparable in both the groups. The onset times for sensory and motor blocks were significantly shorter in A than B Group (P< 0.001), while the duration of blocks was significantly longer (P < 0.001) in A Group. Significantly, onset of action was rapid in Group A patients compared to Group B patients, a higher number of patients in Group B requested for rescue analgesia during the post-operative period than in Group A. The average time duration of surgery in Group A is 79.8±12 minutes and 72.72±11 minutes in Group B. The average time for first request for rescue analgesia were 279.16 mins. and 218.64 mins. in Group A and B respectively. CONCLUSION Butorphanol added as an adjuvant to levobupivacaine for supraclavicular brachial plexus block significantly shortens the onset time and prolongs the duration of sensory and motor blocks and duration of analgesia. Patients in Group A were adequately sedated (Modified Ramsay Sedation Score, RSS = 2/6 or 3/6) with no adverse effects. KEYWORDS Analgesia, Levobupivacaine, Butorphanol, Supraclavicular Brachial Plexus Block. HOW TO CITE THIS ARTICLE: Bommalingappa B, Channabasappa SM. Butorphanol as an adjuvant to levobupivacaine in supraclavicular brachial plexus block for upper limb orthopaedic surgeries: a randomized, double blind, placebo controlled study.