Comparison of effect of 0.5% ropivacaine with fentanyl versus 0.5% ropivacaine with buprenorphine in axillary brachial plexus blocks for isolated hand and forearm injuries

Background: Adjuvants with local anaesthetics prolong postoperative analgesia with early ambulation and lesser side effects. Here we compared fentanyl and buprenorphine as adjuvants to 0.5% ropivacaine in axillary brachial plexus block (ABPB). Methods: Seventy-eight patients belonging to ASA physical status 1 or 2, aged 20–65 years, undergoing surgery for isolated hand and forearm injuries were divided randomly into three groups. Ultrasound-guided ABPB was performed with 20 ml of ropivacaine 0.5% and 1ml of 0.9% saline (Group C) or 20 ml of ropivacaine 0.5% and and 50 µg fentanyl (Group F) or 20 ml of ropivacaine 0.5% and 300µg buprenorphine (Group B). The onset and duration of sensory and motor block and analgesia, total dose of rescue analgesic and haemodynamic parameters were measured. Results: In Group B, the mean time of onset of sensory and motor block was earlier than the other groups. The mean duration of sensory block, motor block and analgesia was longest in Group B followed by Group F and then Group C (P< 0.05). The mean dose of rescue analgesic was higher in Group C compared to Group F and Group B (P< 0.001). The haemodynamic parameters were comparable in the three groups and no adverse effects were seen. Conclusion: Fentanyl or buprenorphine as adjuvant to 0.5% ropivacaine in ABPB prolonged the duration of sensory and motor block and post operative analgesia. Ropivacine with buprenorphine had a short onset of sensory and motor block than Ropivacaine with fentanyl and Ropivacaine alone.