Postoperative analgesia comparing levobupivacaine and ropivacaine for brachial plexus block: A randomized prospective trial.
BACKGROUND
On a pharmacologic basis, levobupivacaine is expected to last longer than ropivacaine. However, most reports of these anesthetics for brachial plexus block do not suggest a difference in analgesic effect. The aim of this study is to compare the postoperative analgesic effects of levobupivacaine and ropivacaine when used for treating ultrasound-guided brachial plexus block.


METHODS
A total of 62 patients undergoing orthopedic surgery procedures were prospectively enrolled and randomized to receive levobupivacaine (group L, N = 31) or ropivacaine (group R, N = 31). The duration of analgesia, offset time of motor block, need for rescue analgesics, and sleep disturbance on the night of surgery were recorded. Pain score was recorded on the day of surgery, and on postoperative days 1 and 2.


RESULTS
There was no difference in the time interval until the first request for pain medication comparing the two groups (group L: 15.6 [11.4, 16.8] hours; group R: 12.5 [9.4, 16.0] hours, P = 0.32). There was no difference in the duration of motor block (group L: 12.2 [7.6, 14.4] hours; group R: 9.4 [7.9, 13.2] hours, P = 0.44), pain score (P = 0.92), need for rescue analgesics (group L: 55%; group R: 65%, P = 0.6), or rate of sleep disturbance (group L: 61%, group R: 58%, P = 1.0) on comparing the two groups.


CONCLUSIONS
There was no difference in postoperative analgesia comparing levobupivacaine and ropivacaine when used for brachial plexus block.
Department of Anesthesiology, Kyorin University School of Medicine, Shinkawa, Mitaka, Tokyo, Japan Department of Surgery, Jichi Medical University, Yakushiji, Shimotsuke, Tochigi, Japan Department of Anesthesia, Hino Munichipal Hospital, Tamadaira, Hino, Tokyo, Japan.
Kunitaro
K
Watanabe
Joho
J
Tokumine
Alan Kawarai
AK
Lefor
Kumi
K
Moriyama
Hideaki
H
Sakamoto
Tetsuo
T
Inoue
Tomoko
T
Yorozu
D000368:Aged; D000577:Amides / Q000008:administration & dosage / Q000627:therapeutic use*; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000627:therapeutic use*; D065527:Brachial Plexus Block / Q000379:methods*; D002045:Bupivacaine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D000077554:Levobupivacaine; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods*; D010149:Postoperative Pain / Q000517:prevention & control*; D011446:Prospective Studies; D000077212:Ropivacaine; D013997:Time Factors; D018084:Ultrasonography, Interventional
D000577:Amides; D000779:Anesthetics, Local; D000077212:Ropivacaine; D000077554:Levobupivacaine; D002045:Bupivacaine