This randomized double-blind study compared the efficacy of 0.5% ropivacaine, 0.75% ropivacaine, and 0.5% bupivacaine for supraclavicular brachial plexus block in upper limb surgeries. Sixty ASA grade I and II patients were randomly allocated into three groups of 20 patients each. Group I received 30 ml of 0.5% ropivacaine, Group II received 30 ml of 0.75% ropivacaine, and Group III received 30 ml of 0.5% bupivacaine.
The primary outcomes assessed were onset and duration of sensory and motor blockade, dermatomal sparing, and duration of analgesia. Secondary outcomes included pain scores, analgesic consumption within 24 hours, hemodynamic parameters, and adverse effects. Results demonstrated that both concentrations of ropivacaine produced a significantly faster onset of sensory and motor block compared to bupivacaine (p<0.05). However, the duration of sensory and motor blockade was shortest with 0.5% ropivacaine (p<0.001). Dermatomal sparing and postoperative pain scores were comparable among all groups. The total requirement for rescue analgesia was significantly lower in the 0.75% ropivacaine group (p<0.001). Hemodynamic stability and incidence of complications were similar across all groups. The study concluded that 0.75% ropivacaine provided superior block characteristics and reduced postoperative analgesic requirements without increasing adverse effects. [/read]