• Orawan Pongraweewan, Nipa Inchua, Chanatthee Kitsiripant, Benchawan Kongmuang, and Wannapa Tiwirach.
• J Med Assoc Thai. 2016 May 1; 99 (5): 589-95.

ObjectiveTo reduce the onset of 0.5% bupivacaine by adding 2% lidocaine with 0.5% bupivacaine for ultrasound-guided and double stimulation technique at musculocutaneous and radial nerve for infraclavicular brachial plexus block.DesignProspective randomized double-blinded, controlled trial study.Material And Method90 patients undergoing creation of arteriovenous fistula under ultrasound-guided infraclavicular brachial plexus block were randomized into 2 groups. Gr B (46 patients) received 0.5% bupivacaine 30 mL and Gr BL (44 patients) received mixture of 0.5% bupivacaine 20 mL and 2% lidocaine 10 mL. The onset of sensory block were assessed by response to pinprick (grading: 0 = no sensation, 1 = hypoesthesia, and 2 = normal sensation). Rescue analgesia during the operation, duration of sensory and motor blockade were recorded. Surgeon and patient satisfactions are also evaluated using 6-point scale (0 = dissatisfied to 5 = very satisfied).ResultsThere were no significant difference in the onset time of either group. Duration of sensory and motor block was not different. Surgeons' and patients' satisfaction were also not significantly different between the groups.ConclusionMixing 2% lidocaine with 0.5% bupivacaine to the final concentration of 0.67%for lidocaine and 0.33% for bupivacaine does not reduce the onset of ultrasound-guided infraclavicular brachial plexus block.

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