The effect of addition of lidocaine to bupivacaine on anesthesia beginning time, block time, and block quality in lateral sagittal infraclavicular block

To investigate whether a 2% lidocaine addition to 0.5% bupivacaine that is used in a lateral sagittal infraclavicular block, when administered in an upper extremity surgery, decreases the block onset time, drug effect time, and drug activity when compared with bupivacaine alone. Materials and methods: This study was performed on 120 American Society of Anesthesiology classification I-II patients who were 18–65 years old and scheduled to undergo an upper extremity surgery. The group testing in the study was as follows: 20 mL (5 mg/mL) bupivacaine, 10 mL (5 mg/mL) bupivacaine + 10 mL (20 mg/mL) lidocaine, and 20 mL (20 mg/mL) lidocaine were used respectively in the bupivacaine group, bupivacaine + lidocaine group, and lidocaine groups. Results: The block onset time was very long in the bupivacaine group (P < 0.001). Motor block developed the fastest in the lidocaine group and the bupivacaine + lidocaine group (P < 0.001). Motor block regression was the fastest in the lidocaine group and the slowest in the bupivacaine + lidocaine group (P < 0.001). Loss of cold and touch sense was the fastest in the bupivacaine + lidocaine group and the lidocaine group (P < 0.001). Loss of sense of pain was the fastest in the bupivacaine + lidocaine group (P < 0.001). Postoperative analgesia requirement time was the longest in the bupivacaine + lidocaine group (P < 0.001). There were no differences among the satisfaction scores. Conclusion: Lidocaine addition to bupivacaine significantly lowered the block onset time and extended the postoperative analgesia requirement time compared to bupivacaine alone and had no effect