Comparison of Ultrasound-Guided Supraclavicular Brachial Plexus Block Using Bupivacaine Alone and in Combination with Buprenorphine for Elective Upper Limb Orthopedic Surgeries

Background: Ultrasound-guided supraclavicular brachial plexus block is a reliable regional anesthesia technique for upper limb surgeries, providing effective intraoperative anesthesia and postoperative analgesia. This study compares the efficacy and safety of bupivacaine alone versus a combination of bupivacaine and buprenorphine in prolonging analgesia and improving postoperative outcomes. Methods: Sixty patients (ASA I/II) undergoing elective upper limb orthopedic surgeries were randomly divided into two groups. Group A received 24 mL of 0.25% bupivacaine with 1 mL normal saline, while Group B received 24 mL of 0.25% bupivacaine with 3 µg/kg buprenorphine. Outcomes assessed included sensory and motor block onset times, duration of analgesia, hemodynamic parameters, sedation scores, and postoperative analgesic requirements Results: Both groups were comparable in demographic characteristics and hemodynamic stability. Group B demonstrated a significantly prolonged duration of analgesia (8.70 ± 0.89 hours) compared to Group A (5.15 ± 0.49 hours; p < 0.05). The time to first rescue analgesia was significantly delayed in Group B (13.30 ± 1.50 hours) versus Group A (7.10 ± 0.80 hours). Sensory block onset was slightly delayed in Group B (13.16 ± 1.17 minutes) compared to Group A (12.50 ± 1.25 minutes; p < 0.05), but motor block onset was similar between groups (p > 0.05). Postoperative pain scores were lower in Group B, with minimal side effects observed in both groups. Conclusion: The addition of buprenorphine to bupivacaine in ultrasound-guided supraclavicular brachial plexus blocks significantly extends the duration of postoperative analgesia and delays rescue analgesic requirements without compromising safety. This combination provides an effective and reliable anesthetic option for upper limb orthopedic surgeries.