1Assistant Professor, Department of Anaesthesiology, JJM Medical College, Davangere
2Professor & Head, Department of Anaesthesiology, Mysore Medical College & Research Institute, Mysore
*Corresponding author: Dr. Madhu K P, 1112/39, AMBA NIVAS ”3rd Cross Taralabalu Badavane, Davangere 577005, Phone: 9448727374, E-mail: drmadhukp@gmail.com
Online published on 1 October, 2015.
To compare the efficacy of Ropivacaine 0.75% with Bupivacaine 0.5% for subclavian perivascular Brachial plexus block.
After informed consent, 60 ASA I/II patients aged between 18–75 years, posted for elective upper limb orthopaedic surgeries were enrolled in a prospective, randomized, double blind study, to receive 0.4ml/kg of either Ropivacaine 0.75% (R group n=30) or 0.4ml/kg of Bupivacaine 0.5% (B group n=30). Supraclavicular brachial plexus block was done in all patients with one of the study drug employing subclavian perivascular approach described by Winnie’. Onset of sensory and motor block, quality of motor block, overall quality of block and duration of sensory and motor block were evaluated in the C5 to T1 dermatomes. The values obtained were statistically analyzed and the results with P value <0.05 were considered statistically significant.
Onset times and duration of sensory and motor block were similar between both groups with no statistical difference. The mean onset time of sensory block was 3.65 ±2.91 min and 4.23±1.59 min in Ropivacaine group and Bupivacaine group respectively (P= 0.132). Onset time of motor blockade was 4.63±3.64 min in R group and4.4±2.02 min in B group (P= 0.76). Quality of motor block was comparable between both groups being complete paralysis in majority of the patients except for 2 cases in R group and 3 cases in B group (P=0.64). Overall quality of block was satisfactory in 93.33% patients in Ropivacaine group and 90% in Bupivacaine group (P=0.64). Duration of sensory block was 555.14±162.26 min in R group and 594.33±158.73 min in B group (P=0.369). Duration of motor blockade was 596.04±154.14 min in R group and 598.52±141.13 min in B group (P=0.95). There were no adverse events noted in either group
0.4ml/kg Ropivacaine 0.75% produced effective and well tolerated brachial plexus block of long duration by the subclavian perivascular route which is similar to that of 0.4ml/kg of 0.5% Bupivacaine. Because Ropivacaine has a potentially improved safety profile compared with Bupivacaine, it may offer an advantage.
Ropivacaine, Bupivacaine, brachial plexus block, subclavian perivascular approach, upper limb surgeries, Winnie
