Ropivacaine a better alternative to bupivacaine: A comparative study of 0.75% ropivacaine vs 0.5% bupivacaine for analgesic efficacy under supraclavicular brachial plexus block
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 2, Pages 2115-2126
AbstractBackground and Objectives: Patients undergoing forearm surgeries have benefited considerably with the widespread use of brachial plexus block instead of general anaesthesia. This study was conducted to investigate the efficacy of 0.75% Ropivacaine in supraclavicular brachial plexus block and to compare the results with 0.5% bupivacaine, which is already established as local anaesthetic for regional anaesthesia.
Methods: Sixty patients of ASA-I and II consenting adult patients undergoing elective upper limb surgeries were randomly divided into Group A and Group B. Group A received 30 ml of 0.5% Bupivacaine and Group B received 0.75% Ropivacaine in supraclavicular block after authenticating the position of brachial plexus with nerve stimulator. Patients were monitored for peak onset and duration of sensory and motor blockade and post-operative analgesia using visual analogue scale. Patients were also observed for any complications during the surgery and in the postoperative period. Sensory and motor block peak and duration of analgesia were evaluated statistically using unpaired t-test and p-value <0.05 was considered significant.
Results: There were no significant differences between the study groups with respect to pattern of changes in Heart rate, Systolic blood pressure, Diastolic blood pressure, Mean arterial pressure perioperatively.
Peak sensory blockade was attained faster in Group B (Ropivacaine) i.e. 13.10 ±2.5 minutes compared to Group A (Bupivacaine) i.e. 23.33 ±3.1 minutes which is statistically significant. Duration of sensory blockade was also longer in Group B (Ropivacaine) i.e. 720.66 ±38.09 minutes compared to Group A (Bupivacaine) i.e. 672.66 ±105.95 minutes and is statistically significant. Onset of Motor blockade was faster in Group B (Ropivacaine) i.e. 18.03 ±2.4 minutes compared to Group A (Bupivacaine) i.e. 24.76±3.1 minutes which is statistically significant. Duration of Motor blockade in Group A (Bupivacaine) was 637.100 ±88.72 minutes compared to Group B (Ropivacaine) i.e. 646.17 ±38.07 minutes and is statistically
European Journal of Molecular & Clinical Medicine
Volume ISSN 2515-8260 09, Issue 02, 2022
not significant. Also, the time for demand of rescue analgesics was prolonged in Group B (Ropivacaine) i.e. 752.66 ±40.33 minutes compared to Group A (Bupivacaine) i.e. 694.56 ±106.14 minutes and this difference is statistically significant.
Conclusion: Ropivacaine 0.75% has an added advantage over Bupivacaine 0.5% for Supraclavicular Brachial Plexus block in terms of early onset of sensory and motor blockade, prolonged duration of sensory blockade, and prolonged duration of analgesia leading to lesser requirement of rescue analgesic. The side effects and complications rate are almost negligible in both groups. Thus Ropivacaine even at higher concentrations of 0.75% and 30 ml volume has proven to be an absolutely safe local anaesthetic. So on the basis of our study we conclude that Ropivacaine 0.75% is an excellent choice for local anaesthetic, which provides better and safer regional anaesthesia.
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