Supraclavicalar Brachial Plexus Block for Upper Limb Orthopedic Surgery: A Randomized , Double Blinded Comparison Between Ropivacaine And Bupivacaine

D. C. Tripathi, Komal S Shah, C. Shah, Samir M. Shah, Emon K Das
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引用次数: 13

Abstract

Background: Ropivacaine is recently introduced in Indian market and needs to be evaluated for its clinical efficacy and safety profile in regional anesthesia. We evaluated ropivacaine for its anesthetic and safety profile in brachial plexus block for upper limb orthopedic surgery and its clinical comparison with bupivacaine.Patients and method: This prospective, randomized, double blind clinical study was carried out in 60 consenting adults of either sex, aged 20-40 yrs, scheduled for elective upper limb orthopedic surgery. Patients were randomly allocated to one of the two groups of 30 patients each. Group B received 30 ml of 0.5% bupivacaine and Group R received 30ml of 0.75% ropivacaine in Supraclavicular brachial plexus block after confirming the proximity of brachial plexus with nerve locator. Patients were observed for onset, peak and duration of sensory and motor blockade, post-operative analgesia using visual analogue scale and complications if any.ResultsIn comparison to equal volume of 0.5% bupivacaine, 0.75% ropivacaine provides earlier onset and peak of sensory blockade (p 0.05). Though, it provides earlier onset of motor blockade (p<0.05), there is statistically significant delay in achieving peak effect as compared to bupivacaine (p<0.05). Haemodynamic remained stable and no complications were encountered in both the groups.Conclusion – We conclude that 30ml of 0.75% ropivacaine has effective anaesthetic and safety profile in Supraclavicalar brachial plexus block with excellent post operative analgesia. We recommend this dose of ropivacaine against equal volume of 0.5% bupivacaine for achieving earlier onset of sensory and motor blockade.
锁骨上臂丛阻滞用于上肢骨科手术:罗哌卡因和布比卡因的随机双盲比较
背景:罗哌卡因最近进入印度市场,需要对其在区域麻醉中的临床疗效和安全性进行评估。我们评估了罗哌卡因在上肢矫形手术臂丛阻滞中的麻醉作用和安全性,并与布比卡因进行了临床比较。患者和方法:这项前瞻性、随机、双盲临床研究在60名年龄在20-40岁、自愿接受上肢矫形手术的成年人中进行。患者被随机分配到两组,每组30名患者。经神经定位器确认臂丛接近后,B组给予0.5%布比卡因30ml, R组给予0.75%罗哌卡因30ml,在锁骨上臂丛阻滞。观察患者感觉和运动阻滞的发生、高峰和持续时间,术后镇痛(视觉模拟评分)和并发症(如有)。结果0.75%罗哌卡因与等体积0.5%布比卡因相比,感觉阻滞的起效和峰值更早(p < 0.05)。虽然,它提供了更早的运动阻断发作(p<0.05),但与布比卡因相比,在达到峰值效果方面存在统计学上显著的延迟(p<0.05)。两组患者血流动力学稳定,无并发症发生。结论:30ml 0.75%罗哌卡因对锁骨上臂丛神经阻滞具有有效的麻醉效果和安全性,术后镇痛效果良好。我们推荐使用此剂量的罗哌卡因,而不是等体积的0.5%布比卡因,以实现感觉和运动阻断的早期发作。
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