Measurement of bupivacaine induced myotoxicity in interfascial plane blocks: A randomised controlled trial.

Background And Aims: Recent reports of local-anaesthetic induced myotoxicity after peripheral nerve blocks have increased interest in this less commonly known complication. Although the morphological, physiological and biochemical changes in muscle after injection of clinically used concentration of bupivacaine have been studied in animals, little research has been conducted on human subjects, especially in relation to fascial plane blocks. We conducted a study to examine the changes in circulating creatine phosphokinase (CPK) levels in patients undergoing modified radical mastectomy (MRM) or mesh hernioplasty (MH) with or without peripheral nerve blocks.