Supraclavicalar Brachial Plexus Block for Upper Limb Orthopedic Surgery: A Randomized , Double Blinded Comparison Between Ropivacaine And Bupivacaine

Background: Ropivacaine is recently introduced in Indian market and needs to be evaluated for its clinical efficacy and safety profile in regional anesthesia. We evaluated ropivacaine for its anesthetic and safety profile in brachial plexus block for upper limb orthopedic surgery and its clinical comparison with bupivacaine.Patients and method: This prospective, randomized, double blind clinical study was carried out in 60 consenting adults of either sex, aged 20-40 yrs, scheduled for elective upper limb orthopedic surgery. Patients were randomly allocated to one of the two groups of 30 patients each. Group B received 30 ml of 0.5% bupivacaine and Group R received 30ml of 0.75% ropivacaine in Supraclavicular brachial plexus block after confirming the proximity of brachial plexus with nerve locator. Patients were observed for onset, peak and duration of sensory and motor blockade, post-operative analgesia using visual analogue scale and complications if any.ResultsIn comparison to equal volume of 0.5% bupivacaine, 0.75% ropivacaine provides earlier onset and peak of sensory blockade (p 0.05). Though, it provides earlier onset of motor blockade (p<0.05), there is statistically significant delay in achieving peak effect as compared to bupivacaine (p<0.05). Haemodynamic remained stable and no complications were encountered in both the groups.Conclusion – We conclude that 30ml of 0.75% ropivacaine has effective anaesthetic and safety profile in Supraclavicalar brachial plexus block with excellent post operative analgesia. We recommend this dose of ropivacaine against equal volume of 0.5% bupivacaine for achieving earlier onset of sensory and motor blockade.