Comparison between Ropivacaine and Bupivacaine for Brachial Plexus Block by Supraclavicular Approach in Upper Limb Orthopaedic Surgeries

Author(s): Mahabubuzzaman M, Kabir SH, Iqbal MJ, Begum SA, Kumar D, Babu MI, Kaisar K, Hasan SMZ, Panna MA, Islam S, Rahman AKMS

Ropivacaine, a relatively recent amino amide local anaesthetic, is known for its reduced risk of cardiac and neurological toxicity compared to bupivacaine or lidocaine. While there has been thorough research on its application in epidural anaesthesia, there is limited documentation regarding its use in brachial plexus blocks. The current investigation aims to compare ropivacaine with bupivacaine concerning the quality of brachial plexus blocks and any associated adverse effects. In this prospective, randomized, double-blind study, seventy elderly patients aged 60 or older, with American Society of Anaesthesiologists (ASA) physical status classifications I and II, underwent upper limb surgery with brachial plexus block, were split into two groups. Group B received bupivacaine with fentanyl and normal saline, while Group R received ropivacaine with fentanyl and normal saline. There were no significant differences between the groups in age, sex, weight, ASA class, surgery duration, or other factors. Group R had faster onset times for sensory and motor blocks and longer sensory block duration compared to Group B (p<0.05). However, there was no significant difference in total motor block duration (p>0.05). Group R also had a longer time before needing rescue analgesia, suggesting potentially extended pain relief compared to Group B (p<0.05). Though Group R showed a trend towards fewer adverse events, these differences were not statistically significant (p>0.05). The benefits of prolonged sensory block for postoperative pain relief and the undesirability of extended motor block along with its impact on patient mobility, the administration of ropivacaine may be regarded as preferable to bupivacaine

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