STUDY OF COMPARISON BETWEEN BUPIVACAINE 0.5% & ROPIVACAINE 0.5%IN ULTRASOUND GUIDED AXILLARY BRACHIAL PLEXUS FOR ELECTIVE UPPER LIMB SURGERIES

Background: This study contains comparison between Bupivacaine 0.5% &Ropivacaine 0.5% in ultrasound guided axillary brachial plexus block in elective upper limb surgeries. It is safer technique compared to GA .Study aims comparison of both local anaesthetic drugs in terms of volume , onset of motor & sensory blockade, duration of motor & sensory blockade & duration of analgesia.

Methods: This randomized, controlled, double blinded study at tertiary care center compared effect of bupivacaine 0.5% and ropivacaine 0.5%. Adults meeting specific inclusion criteria were divided in 2 equal groups 30 patients in each. All patients were given USG guided axillary block. Group A received Inj. Bupivacaine 0.5% 2.5-3 mg/kg (20-30 ml) while group B received Inj. Ropivacaine 0.5% 2-3 mg/kg (20-30 ml). Outcome measured included volume of drug , onset of motor & sensory blockade, duration of motor & sensory blockade. Hemodynamic parameters, VAS score, requirement of rescue analgesic (VAS >4) observed during perioperative period at different intervals. Sensory & motor block were assessed by 3-point scale.VAS score is evaluated by asking the patients to describe their pain between 0 to 10. p-value ≤0.05was considered statistically significant.

Results: Comparison between both groups showed that onset of motor blockade (11.3 ±1.48 min ) & sensory blockade (7.46 ± 1.40 min ) was slower in group A , whereas onset of motor blockade (6.91± 1.39 min) & sensory blockade (3.13 ± 0.84 min) was faster in group B. While duration of motor blockade (681.16 ± 15.23 min) & sensory blockade (745 ± 25.12 min) was prolonged in group A compared to shorter duration of motor blockade (480.83 ± 31.67 min ) & sensory blockade (550.16 ± 39.62 min ) in group B. Duration of Analgesia was longer in group A(1388.83 ± 162.85 min ) compared with group B (856.16 ± 139.51 min ).

Conclusion:Ropivacaine 0.5% is associated with faster recovery of sensory& motor function with better safety profile compared to Bupivacaine 0.5%.