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British Journal of Anaesthesia, Vol 82, Issue 2 217-220, Copyright © 1999 by The Board of Management and Trustees of the British Journal of Anaesthesia

CLINICAL INVESTIGATIONS

Respiratory effects of low-dose bupivacaine interscalene block

A. A. Al-Kaisy, VWS. Chan and A. Perlas
Aintree Hospitals, Liverpool, UK; Department of Anaesthesia, Toronto Hospital, Western Division, 399 Bathurst Street, Toronto, Ontario, Canada M5T 2S8

In this double-blind study, interscalene brachial plexus (ISBP) block was performed in 11 volunteers using 10 ml of either 0.25% (n = 6) or 0.5% (n = 5) bupivacaine with epinephrine 1:200,000. Diaphragmatic excursion, respiratory function and neural function were assessed for 90 min. Our results showed that hemidiaphragmatic excursion declined significantly after block in the 0.5% group and paradoxical movement during inspiration was more common than in the 0.25% group. Forced vital capacity and forced expiratory volume in 1 s declined significantly in the 0.5% group (mean 74.6 (SD 13.0)% and 78.2 (19.9)% of baseline, respectively) but not in the 0.25% group. Sensory anaesthesia in the upper limb was found consistently in both groups, although biceps paralysis occurred earlier after 0.5% bupivacaine. We conclude that ISBP block using 10 ml of 0.25% bupivacaine provided upper limb anaesthesia to pinprick in C5-6 dermatomes with only occasional interference with respiratory function.
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