Ropivacaine versus Bupivacaine for Inter Scalene Block Clinical and Pharmacological Comparative Study | ||
| The Egyptian Journal of Hospital Medicine | ||
| Article 10, Volume 25, Issue 1, October 2006, Pages 691-702 PDF (1.31 M) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/ejhm.2006.17809 | ||
| Authors | ||
| Nagia M. Abd El Moeti1; Zinab B. Youssef1; Soaad Said Abd El Aal1; Enas Abd El Aaty Ouda2 | ||
| 1Anaesthesia Department Faculty of Medicine Al-Azhar University | ||
| 2Department of Pharmacology Faculty of Medicine Al-Azhar University | ||
| Abstract | ||
| Introduction : The interscalene approach to the brachial plexus for shoulder surgeries provides excellent anaesthesia with remarkable safety and minimal or no systemic disturabances. Material and Methods : 60 abult patients ASA I-II undergoing elective shoulder surgery. Patients were randomly allocated into 3 groups. The patients recived 20ml of either ropivacaine 1% GI (20 patients), ropivacaine 0.75% GII (20 patients) and bupivacaine 0.5% GIII (20 patients). Onset time of sensory and motor block, duration of analgesia and the need for supplementary analgesics were recorded. Pain was assessed by using VAPS. Haemodynamic parameters, oxygen saturation and respiratory rate were recorded. Unwanted side effects, cardiovascular, neurological, nausea and vomiting etc were recorded. Also, patients satisfaction were noted. The pharmacological study was done on pentobarbitone cats to determine the effect of different doses of ropivacaine (0.35-2.8mg/kg) versus buipvacaine (0.5-4mg/kg) on arterial blood pressure, ECG and respiratory rate. Results: The mean onset time of analgesia was faster in ropivacaine groups than bupivacaine group (p‹0.005). The studied groups were comparable regarding the duration of analgesia, motor and sensory block, cadio vascular and respiratory effects. The incidence of paraesthesia was more frequent in bupivacaine group than both ropivacaine groups (30% vs 10%) There was more patient satisfaction in ropivacaine groups than bupivacaine groups. On the other hand the pharmacological study showed that ropivacaine had more less toxic effects on cardiovascular and respiratory systems. Conclusion : This study concluded that interscalene block performed with either 0.75% or 1% ropivacaine allows for a prolonged postoperative pain relief similar to bupivacaine 0.5% with shorter onset time, more cardiovascular Introduction : Interscalene brachial plexus block (ISB) is used to provide anaesthesia and analgesia for shoulder surgery. Single injection interscalene brachial plexus block is an effective anaesthetic; however it is limited by the duration of action of local anaesthetic. Bupivacaine and ropivacaine have been compared both at different an equal volumes and concentration for ISB. Kinnard and Lirette, (1996). Bupivacaine is a long-acting local anaesthetic which has been reported to be associated with slower onset time for nerve blockade compared with other intermediate stability and higher patient satisfaction. | ||
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