Axillary brachial plexus block with ropivacaine 7.5 mg/ml. A comparative study with bupivacaine 5 mg/ml.
BACKGROUND
Ropivacaine is less cardiotoxic than bupivacaine and may be used in higher doses in order to increase the quality of a block. The aim of this study was to compare the efficacy and safety of 40 ml ropivacaine 7.5 mg/ml (300 mg) and 40 ml bupivacaine 5 mg/ml (200 mg) for axillary plexus block.


METHODS
One hundred and four adult patients were included in a prospective, double-blind study. Sensory and motor block were tested for the five main terminal nerves of the arm at 10-min intervals until start of surgery and every second hour there-after until full resolution of the block.


RESULTS
The overall evaluation of the block by the surgeon and the anesthesiologist showed a significantly better quality in the ropivacaine patients, regarding both anesthesia and motor block. There were no differences in the time to onset and duration of the block. Except for one patient, who had seizures after an accidental IV injection of ropivacaine, there were no major side effects.


CONCLUSIONS
Ropivacaine 7.5 mg/ml, 40 ml, produces axillary plexus block of similar onset and duration but better quality than 40 ml of bupivacaine 5.0 mg/ml.
Raeder
J C
JC
Dept. of Anesthesiology, Ullevaal University Hospital, Oslo, Norway.
Drøsdahl
S
S
Klaastad
O
O
Kvalsvik
O
O
Isaksen
B
B
Strømskag
K E
KE
Mowinckel
P
P
Bergheim
R
R
Selander
D
D
D000328:Adult; D000577:Amides / Q000008:administration & dosage* / Q000009:adverse effects; D000700:Analgesics / Q000627:therapeutic use; D000779:Anesthetics, Local / Q000008:administration & dosage* / Q000009:adverse effects; D001132:Arm / Q000294:innervation; D001365:Axilla / Q000294:innervation; D001917:Brachial Plexus; D002045:Bupivacaine / Q000008:administration & dosage* / Q000009:adverse effects; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007275:Injections, Intravenous / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009046:Motor Neurons / Q000187:drug effects; D009407:Nerve Block / Q000379:methods; D009475:Neurons, Afferent / Q000187:drug effects; D010149:Postoperative Pain / Q000188:drug therapy; D011446:Prospective Studies; D000077212:Ropivacaine; D012449:Safety; D012640:Seizures / Q000139:chemically induced; D013997:Time Factors
D000577:Amides; D000700:Analgesics; D000779:Anesthetics, Local; D000077212:Ropivacaine; D002045:Bupivacaine