A comparative study to evaluate the effectiveness of 0.5% Levobupivacaine versus 0.5% Ropivacaine in Axillary Brachial plexus block

Abstract

Objective: Levobupivacaine and Ropivacaine having better pharmacological profile in respect of less cardiac and neurological toxicity in comparison of Bupivacaine on accidental intravascular injection. Present study is aimed to compare onset and duration of sensory, motor blockade and analgesia between groups receiving axial plexus block with 0.5% Levobupivacaine/Ropivacaine. Methods: This randomized study included 50 patients of ASA grade I, II, age of 18-65 years of either sex undergoing surgery for forearm and hand. Group L/R received 0.5% Levobupivacaine/Ropivacaine 40ml respectively through axillary brachial plexus block. The onset of sensory and motor block and duration of sensory/motor block and analgesia were recorded. Vital parameters were recorded in intraoperative and postoperative period. Result: Time to onset of sensory and motor block was significantly faster in group R as compared to group L. The mean duration of analgesia in group L was 674.04 ± 82.89 minutes and group R was 513.68 ± 20.14 minutes( p value < 0.001), showing significantly longer duration of analgesia with levobupivacaine . The mean duration of motor block in group L/R was 622.96 ± 99.74 and 407.80 ± 20.72 minutes respectively (p value < 0.001). No clinically significant difference in vital parameters was noted. Conclusion: Onset of sensory and motor block was significantly faster with ropivacaine than levobupivacaine, but duration of analgesia and motor block was significantly prolonged with levobupivacaine hence suggesting levobupivacaine a better choice in axillary block to address the need of longer postoperative analgesia and motor block.