Abstract
Objectives: To compare the effect of 35 ml of 0.375% bupivacaine and 35 ml of 0.375% ropivacaine in supraclavicular brachial plexus block. Materials and Methods: In this prospective double blind study, sixty patients of ASA- I and II scheduled for upper limb orthopedic surgeries were randomly divided into Group B and Group R which received 35 ml of 0.375% bupivacaine and 0.375% ropivacaine respectively. Sensory and motor block onset& duration and duration of analgesia were evaluated statistically using unpaired t-test and p-value < 0.05 was considered significant. Results: The sensory and motor onset (mean-minutes) was 21.13 and 25.87 in group Band was 13.3 and 21.37 in group R respectively. The duration of sensory and motor block (mean- minutes) was 480.3 and 472.8 in group R, and 472.1 and460.2 in group B The duration of post-operative analgesia was 504.2 minutes in Group R and 499.6 minutes in Group B. Conclusion: Group R provided statistically significant & rapid onset of sensory and motor blockade than Group B for upper limb surgeries. There were no significant differences in duration of sensory and motor blockade, any complication or side effects. Ropivacaine may be a preferred option because of its higher therapeutic index.
Highlights
Regional nerve blocks are based on the concept that pain is conveyed by nerve fibers, which are amenable to interruption anywhere along their pathway
Ropivacaine was developed after it was noted that bupivacaine was associated with significant number of cardiac arrests
The average onset time for Sensory and motor block is shown in Table 2.The onset in Group R patients was faster for both Sensory and Motor block compared to Group B patients
Summary
Regional nerve blocks are based on the concept that pain is conveyed by nerve fibers, which are amenable to interruption anywhere along their pathway. This was followed by the alternate intensity theory of Erb in 1874.[1]. Regional anaesthesia was not available when general anaesthesia was first successfully administered in 1846. It had to wait until 1855 when Rynd described the idea of introducing a solution of morphine hypodermically around a peripheral nerve. Because he did not have a needle or a syringe, he improvised by introducing a trocar and cannula into the region and allowing the solution to reach the nerves by gravity.[2]
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