Comparative evaluation of 0.5% Ropivacaine and 0.5 % Bupivacaine in Supraclavicular Brachial plexus block

Abstract

Background: Brachial plexus blocks are commonly used for forearm and hand surgeries but due to adverse effect like cardiotoxicity there is lot of research going on to find more cardiostable agent. Ropivacaine is commonly tried now adays in place of bupivacaine for brachial plexus block. It is new amino amide local anaesthetic having less cardiac toxicity as compared to bupivacaine. Aim: The present study was performed at our Institute to compare the Clinical characteristics of 0.5% ropivacaine and 0.5% bupivacaine when used for supraclavicular brachial plexus block in forearm and hand surgeries. Materials and Method: In this prospective randomised study sixty patients of ASA-I and II scheduled for forearm and hand surgeries under supraclavicular brachial plexus block were randomly divided into two groups of thirty each. Group R received Ropivacaine 0.5% 20 ml + 10ml normal saline while Group B received Bupivacaine 0.5% 20 ml + 10ml normal saline. Mean pulse, blood pressure,onset of sensory and motor blockade, duration of analgesia, and side effecs of local anaesthetic used were noted in both the groups. Statistical analysis for clinical characterstics was done by student t test and ANOVA was used to analyze hemodynamic variations between two groups. p<0.05 considered as significant and p<0.01 considered as highly significant. Results: Mean onset time of sensory blockade was 5.5 ± 0.89 mins in Group R and 6.5 ± 0.65mins in Group B and motor blockade was 14.3 ± 2.64 mins in Group R and 12.4 ±2.06 mins in Group B. Mean duration of Analgesia in Group R was 432 ± 18.2 mins and in Group B was 492 ± 20.3 mins. There was no statistical significant difference in onset of sensory block, motor block and mean duration of analagesia between two groups (p>0.05). Conclusion: Supraclavicular brachial plexus block using either 0.5% Ropivacaine or 0.5% Bupivacaine have similar onset of sensory and motor blockade, duration of analgesia but due to potentially proven safety profile in the literatue compared to bupivacaine it may offer an advantage in modern clinical practice.