Background: The racemic bupivacaine is commonly used local anaesthetic drug brachial plexus block in as it provides longer duration of action but has risk of cardiotoxicity .The use of levobupivacaine in brachial plexus block seems promising considering its lower toxicity and the need of large volumes in this block. However there is possibility of unsatisfactory motor blockade. Aim: To compare the efficacy and side effects of bupivacaine and levobupivacaine in brachial plexus block by supraclavicular approach. brachial plexus block Methods: This study included 60 patients belonging to ASA grade I and II, either sex, between age group of 18 to 65 years and above, undergoing hand, forearm and arm surgery under supraclavicular block. These patients were randomly divided into two groups. The patients received 30 ml 0.5% bupivacaine (Group B) or 30 ml 0.5% levobupivacaine (Group L). Motor and sensory blocks were evaluated. Sensory and motor block onset times, durations of sensory and motor block and duration of postoperative analgesia were recorded. Results: The two study groups were homogeneous with respect to age, sex, body weight and diagnosis type (type of fractures) and duration of surgery. The sensory and motor block onset times in Group B were significantly shorter than Group L (p < 0.05). The onset of sensory block was 9.33 + 3.27 min. in group B whereas, it was 16.13 + 2.83 min. in group L. The onset of motor block was 12.17 + 2.18 in group B, whereas it was 20.00 + 2.79 in group L. Sensory and motor block durations of Group B and L patients did not vary statistically significantly. In the present study, the mean duration of post operative analgesia was statistically insignificant between the two group (p= 0.766). It was 193.56 + 23.51 in group B and 192.83 + 23.54 in group L. Conclusion: 30 ml 0.5% bupivacaine and levobupivacaine was enough to achieve adequate supraclavicular block. Bupivacaine leads to faster sensory and motor block onset compared to levobupivacaine; however it has similar duration of postoperative analgesia.

Keywords: Supraclavicular Block; Bupivacaine; Levobupivacaine; Cardiotoxicity.