Comparision between bupivacaine and ropivacaine in patients undergoing forearm surgeries under axillary brachial plexus block: a prospective randomized study.
BACKGROUND
Brachial plexus block is a suitable alternative to general anaesthesia for patient undergoing upper extremity surgery. Ropivacaine the S-enantiomer emerged as a possible replacement of Bupivacaine without undesirable toxic effects. It provides similar duration of sensory analgesia with early recovery of motor block.


OBJECTIVE
Comparision of onset, duration of sensory- motor block and any adverse effects between 0.5% Bupivacaine and 0.5% Ropivacaine in axillary brachial plexus block.


METHODS
Prospective randomized study.


METHODS
This study was carried out in 50 patients between 18-55 y, comparable in demographic variables was randomly allocated to two groups of 25 each. Group I received 30ml 0.5% Bupivacaine, Group II received 30 ml 0.5% Ropivacaine in axillary brachial plexus block for forearm surgeries. Onset, Duration of sensory-motor block, Heart rate, Blood pressure, Oxygen saturation and Respiratory rate were recorded.


METHODS
Statistical analysis used was Statistical Package for Social Sciences version 15.0, Chi-square test was used to evaluate the proportional data. Odds ratio/risk ratios have been calculated wherever necessary. Parametric data has been evaluated using Student t-test while non-parametric data has been evaluated using Mann-Whitney U-test.


RESULTS
Onset of motor blockade was earlier in ropivacaine group (5 min) as compared to bupivacaine group (20 min), Higher levels of motor blockade, Mean onset time for motor block was significantly shorter in ropivacaine group (14.88±3.35 min) as compared to bupivacaine group (22.92±3.79 min), Mean duration of block was significantly longer in bupivacaine group (408.40±50.39 min) as compared to ropivacaine group (365.60±34.29 min) (p=0.001), Onset of sensory block was observed from 5 min itself in ropivacaine group as compared to bupivacaine group (10 min), Duration of sensory block was significantly longer in bupivacaine group (450.40±54.50 min) as compared to ropivacaine group (421.20±38.33 min) .


CONCLUSIONS
On the basis of present study, conclusions were drawn that onset of action of sensory, motor block was early in Ropivacaine group with faster recovery of motor functions as compared to Bupivacaine group. No adverse effects were noted in either groups. This study suggests that Ropivacaine is a suitable alternative to Bupivacaine for forearm surgeries under Brachial Plexus Block.
Senior Resident, Department of Anaesthesiology and Critical Care, ESI Hospital , Gurgaon, Haryana, India .
Anupreet
A
Kaur
Assistant Professor, Department of Anaesthesiology and Critical Care, Era's Lucknow Medical College and Hospital , Lucknow, UP, India .
Raj Bahadur
RB
Singh
Assistant Professor, Department of Anaesthesiology and Critical Care, Era's Lucknow Medical College and Hospital , Lucknow, UP, India .
R K
RK
Tripathi
Assistant Professor, Department of Anaesthesiology and Critical Care, Era's Lucknow Medical College and Hospital , Lucknow, UP, India .
Sanjay
S
Choubey
Axillary block; Brachial plexus block; Bupivacaine; Fore arm; Ropivacaine