Key result
Bupivacaine 0.5% resulted in earlier onset of sensory blockade and prolonged duration of analgesia compared to ropivacaine 0.5% for supraclavicular brachial plexus block.
Why the study?
Does bupivacaine 0.5% improve the onset and duration of sensory and motor blockade compared to ropivacaine 0.5% in adult patients undergoing elective upper limb surgeries?
RCT (n=60)
Simple random sampling
No
Does bupivacaine 0.5% improve the onset and duration of sensory and motor blockade compared to ropivacaine 0.5% in adult patients undergoing elective upper limb surgeries?
Bupivacaine 0.5% provides faster onset and longer duration of sensory and motor blockade compared to ropivacaine 0.5% for supraclavicular brachial plexus block in adult patients.
This is the authors' abstract. We don't add key points for this paper.
Introduction: Peripheral nerve blocks have become important in clinical practice because of their role in post-operative pain relief, shortening of patient recovery time & avoiding risks and adverse effects of general anaesthesia. Bupivacaine is a long acting local anaesthetic. Due to its long duration of action and combined with its high quality sensory blockade compared to motor blockade it has been the most commonly used local anaesthetic for peripheral nerve blocks. Ropivacaine is a newer, long acting local anaesthetic whose neuronal blocking potential used in peripheral nerve blockade seems to be equal or superior to bupivacaine. Studies show that it has significantly greater safety margin over bupivacaine. Hence here is an attempt through the study to compare bupivacaine with ropivacaine in supraclavicular brachial plexus block in adult patients. Aims and Objectives: To compare the effect of bupivacaine 0.5% & ropivacaine 0.5% used for supraclavicular approach to brachial plexus block with respect to onset time of sensory blockade, onset time of motor blockade, duration of sensory blockade, duration of motor blockade, duration of analgesia, side effects/ complications. Method of Collection of Data: Sixty patients aged between 18 years and 60 years, of physical status ASA grade 1 and ASA grade 2 undergoing elective upper limb surgeries lasting more than 30 minutes were included in the study after getting ethical clearance. Each patient was randomly allocated to one of the two groups of 30 patients each. The patients were explained about the procedure and premedicated with tab alprazolam 0.5mg, and tab ranitidine 150 mg. The anesthetic technique employed was supraclavicular brachial plexus block using 30 ml of either 0.5% bupivacaine or 0.5% ropivacaine Results: In our study, we observed that onset time of sensory block was earlier in bupivacaine group (Group B) having a mean value of 15.702.35 minutes in comparison with ropivacaine group (Group R) having a mean value of 20.133.05 minutes, which is statistically significant. onset time of motor block was earlier in bupivacaine group (Group B) having a mean value of 20.432.22 minutes in comparison with ropivacaine group (Group R) having a mean value of 22.901.88 minutes which is statistically significant.
Answers are grounded in this paper and cite their sources.
Bupivacaine 0.5% may be preferred for supraclavicular blocks needing rapid onset; confirms advantages over ropivacaine in upper limb surgery RCTs.
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Piruthiviraj Natarajan (2016) conducted an RCT in Elective upper limb surgeries (n=60). Bupivacaine vs. Ropivacaine 30 ml of 0.5% was evaluated on Onset time of sensory blockade (minutes) (p=<0.001). Bupivacaine 0.5% resulted in earlier onset of sensory blockade and prolonged duration of analgesia compared to ropivacaine 0.5% for supraclavicular brachial plexus block.
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