A prospective randomized double blind comparative study of 0.5% ropivacaine and 0.5% bupivacaine in brachial plexus block with supraclavicular approach in upper limb surgeries using peripheral nerve l

Introduction: Racemic Bupivacaine is a commonly used local anesthetic. Ropivacaine, an enantiomerically pure stereo-isomer of Bupivacaine is now available in India. Previous studies have proved the suitability of Ropivacaine for neural blockade by different routes. Aims: Our prospective, randomized, double blind study aimed to compare 0.5% Ropivacaine with 0.5% Bupivacaine for nerve-locator aided Supraclavicular Brachial Plexus Anesthesia in terms of onset, duration and quality of anesthesia. Materials and Method: 62 ASA I &II patients undergoing upper limb surgeries received 3mg/kg of 0.5% Ropivacaine or 0.5% Bupivacaine by Nerve locator aided Supraclavicular Brachial Plexus Block. Results: Group Ropivacaine had an earlier onset of analgesia, sensory and motor blockade (4.61±2.19, 7.03±3.37, 11.00±5.85minutes) as compared to Group Bupivacaine (7.58±3.47, 12.35±8.20 & 18.87±9.26 minutes) with p values of < 0.001, =0.001 and 0.001 respectively. Duration of analgesia, sensory and motor blockade was shorter in Group Ropivacaine (444.2±190.3minutes, 457.0±174.3, 404.4±137.6 minutes) than Group Bupivacaine (662.9±262.6, 650.7±273.8, 640.8±218.1minutes) with p values of <0.001, 0.002 and < 0.001 respectively. Conclusion: We found that Ropivacaine in Supraclavicular Brachial Plexus Anesthesia had a faster onset, equivalent degree of sensory-motor blockade and faster recovery than Bupivacaine. 3mg/kg of both drugs showed no adverse effects. Thus 0.5 % Ropivacaine is a safe substitute for 0.5 % Bupivacaine in brachial plexus blocks with special use in ambulatory surgeries.