Abstract

Background: Upper extremity surgeries are very common in trauma. There are many methods of blocking for this surgery such as general anesthesia with intubation or laryngeal mask, intravenous anesthesia, brachial plexus anesthesia, intravenous anesthesia. Anesthesia of the brachial plexus has many advantages of both ensuring blockade, avoiding the disadvantages of general anesthesia, and reducing pain after
surgery. In the world, there are many studies of patients anesthetizing brachial plexus with levobupivacaine in different concentrations such as 0.375%, 0.5%, 0.75% with different anesthetic volumes. The aim is to compare the effects of the same dosage but different in concentrations and volume of levobupivacaine in order to find the most appropriate concentration of levobupivacaine for brachial plexus anesthesia.
Methods: The prospective study, randomized, compared 100 patients who had upper limb surgery of 1/3 of the middle of the arm bone or less, using brachial plexus anesthesia under ultrasound guidance combined with stimulator neuromuscular were randomly divided into two groups. Group 1: anesthesia with  evobupivacaine 0.5% dose 2mg/kg. Group 2: anesthesia with levobupivacaine 0.375% dose 2mg/kg. Monitor the time of achievement of sensory suppression, achievement of motor inhibition, duration
of sensory prolongation, motor and pain relief after surgery. Monitor heart rate, blood pressure, respiratory rate, SpO2 and VAS score at 0, 4, 8, 12, 16, 20, 24 hours after surgery, patient satisfaction and effects undesirable in both groups.
Results: The brachial plexus anesthesia success rate in the two groups was 100%. Mean time to achieve sensory and motor inhibition in the group I (9.34 ± 1.61) and 12.94 ± 1.68) minutes shorter than the group II (14.48 ± 2.03 and 17.70 ± 1.73) minutes. Time of motor block, sensory block and postoperative analgesia of group I (8.50 ± 0.87; 10.04 ± 1.09 and 11.64 ± 1.50) hours shorter than the group II (10.46 ± 1.16; 12.37 ± 1.24 and 14.22 ± 1.90) hours. Heart rate, blood pressure, respiratory rate, SpO2 in patients usually vary little during and after surgery. In our study, there were no cases of complications in both groups.
Conclusion: Anesthesia of the brachial plexus upper clavicle line under ultrasound guidance combined with neuromuscular stimulator, the levobupivacaine anesthetic group 0.5% was better effective than the levobupivacaine anesthesia group 0.375% in surgery