Effects of varying concentrations of ropivacaine on pain relief in ultrasound-guided brachial plexus block surgery in the intercostal space

Purpose: To investigate the anesthetic efficacy of various concentrations of ropivacaine in ultrasound-guided brachial plexus block surgery in the inter-costoclavicular space. Methods: 94 patients for brachial plexus block surgery identified from March 2021 to March 2023 in Jilin Province, China were selected as the study subjects; they were divided into control group and study group, and the control group received 0.3% ropivacaine 20 ml while the study group received 20 ml of 0.4% ropivacaine. The nerve block efficiency, secondary evaluation index, VAS scores at 12 h, 24 h and 48 h after surgery and the occurrence of adverse reactions were determined. Results: There was no notable difference in the success rate of nerve block between the control and study group (91.49 % vs 95.74 %, χ2 = 0.712, p = 0.399). In comparison to control, the study group exhibited no noteworthy variance in the commencement time of the sensory block, whereas the remaining three indicators were significantly shortened (p < 0.05). The VAS scores at 12 and 24 h after surgery were markedly lower compared to the control (p < 0.05), while at 48 h, VAS scores were slightly lower (p > 0.05). There was no significant disparity in the overall incidence of adverse reactions between the two groups (4.26 vs. 6.38 %), neither were there serious complications such as tube nerve injury, local anesthetic poisoning, Horner's syndrome, pneumothorax, and postoperative sensory-motor abnormalities (p < 0.05). Conclusion: Using 0.4 % ropivacaine in ultrasound-guided intercostal brachial plexus block surgery achieves a higher success rate, enhances nerve block onset and duration, and improves postoperative pain relief, all without raising the incidence of adverse reactions, when compared to the use of 0.3 % ropivacaine concentration. However, larger clinical trials are required before the application of this strategy in clinical practice.