Ropivacaine 7.5 mg/ml versus bupivacaine 5 mg/ml for interscalene brachial plexus block--a comparative study

Area of Science:

• Anesthesiology
• Pharmacology

Background:

• Interscalene brachial plexus block (ISB) is a common technique for shoulder and upper extremity surgery.
• Ropivacaine and bupivacaine are frequently used local anesthetics for regional anesthesia.

Purpose of the Study:

• To compare the efficacy and safety of ropivacaine 7.5 mg/ml versus bupivacaine 5 mg/ml for ISB combined with general anesthesia.
• To evaluate the onset and quality of sensory and motor block, drug consumption, and postoperative pain.

Main Methods:

• A randomized, double-blind, prospective clinical trial involving 120 patients.
• Patients received ISB using Winnie's technique with a catheter, followed by general anesthesia.
• Assessed sensory and motor block characteristics, local anesthetic, opioid, and neuromuscular blocking drug consumption, and pain using a visual analog scale (VAS).

Main Results:

• Similar onset and development of sensory and motor block between ropivacaine and bupivacaine groups.
• No significant differences in the consumption of neuromuscular blocking drugs or opioids.
• Mean postoperative pain scores (VAS) were below 25 in both groups, with no identified side effects.

Conclusions:

• Ropivacaine 7.5 mg/ml and bupivacaine 5 mg/ml are nearly indistinguishable for interscalene brachial plexus blocks.
• Both agents provide comparable intraoperative and early postoperative analgesia and block characteristics.
• The study supports the use of either ropivacaine or bupivacaine for ISB with similar safety profiles.