A comparative study of 0.5% ropivacaine and 0.5% levobupivacaine in supraclavicular brachial plexus block

Abstract

Background: To compare the clinical profiles of levobupivacaine and ropivacaine at equipotent doses for supraclavicular brachial plexus block for upper limb surgeries, we hypothesized that both will induce a similar upper limb anesthetic blockade in terms of sensory and motor blockades. Objective: To evaluate the effects of levobupivacaine and compare it with ropivacaine in brachial plexus block through supraclavicular route. Materials and Methods: For this prospective study, 60 patients of both sexes ASA I/II were enrolled and divided into two groups, and supraclavicular brachial plexus block was performed using levobupivacaine 0.5% and ropivacaine 0.5% using classical approach. The onset of sensory and motor block, their duration, and possible adverse events were recorded. Result: No statistically significant difference was observed in the onset of sensory block in both the groups. Onset of motor blockade was significantly faster with ropivacaine (9.50 ± 2.403 min) as compared to levobupivacaine (12.33 ± 2.537 min; P < 0.05). Duration of sensory and motor block was significantly short for ropivacaine than levobupivacaine (P < 0.05). Levobupivacaine has significantly longer duration of analgesia (12.56 ± 1.30 h) as compared to ropivacaine (9.93 ± 1.7 h; P < 0.05). Conclusion: Levobupivacaine, a novel long-acting local anesthetic agent, having better profile in terms of duration of analgesia, with a considered disadvantage of delayed wearing off of motor blockade, offers an alternative to ropivacaine for brachial plexus block in upper limb surgeries.