A Comparative Study on Efficacy Between Levobupivacaine and Ropivacaine for Upper Limb Surgeries Under Supraclavicular Brachial Plexus Block

Author(s): Ralte Lalrinmawia1 , Yumnam Arunkumar Singh2 , Takhelmayum Hemjit Singh3 , Rupendra Singh Thokchom4 , Nongthonbam Ratan Singh5 , Ashem Jack Meitei6 , Laithangbam Pradip Kumar Singh7 , Sanasam Sarat Singh8

BACKGROUND Regional anaesthesia technique has increased in modern anaesthesia practice. It is safer, with less haemodynamic changes, intact consciousness, avoiding airway instrumentation, providing rapid recovery and longer postoperative analgesia. However, the toxicity of bupivacaine is a concerning issue. Hence the present study aimed to compare the effectiveness of the newer drugs levobupivacaine and ropivacaine in supraclavicular brachial plexus block. METHODS In this prospective and double blinded study, 60 patients of either sex, aged 18 to 60 years, ASA I and II undergoing upper limb surgeries were randomized into two groups of 30 patients each either to receive supraclavicular brachial plexus block of 0.5% levobupivacaine (Group L) and 0.5% ropivacaine (Group R) respectively to study its efficacy and block characteristics. RESULTS The onset time was faster for sensory (9.40 ± 1.58 mins versus 12.46 ± 1.79 mins; p<0.001) as well as motor (11.26 ± 1.61 mins versus 14.26 ± 1.72 mins; p<0.001) in Group L compared to Group R. The duration of sensory block was also significantly longer in group L compared to group R (742.83 ± 55.62 minutes versus 618.33 ± 64.27 minutes) and the duration of motor block was significantly longer in group L compared to group R (689.50 ± 45.85 minutes versus 548.16 ± 57.48 minutes; p<0.01). The time to first rescue analgesia was longer in group L compared to group R (792.66 ± 62.6 minutes versus 661.50 ± 62.87 minutes; p<0.01). CONCLUSIONS Levobupivacaine provided faster onset of sensory and motor block, longer duration of sensory and motor block with better postoperative analgesia than ropivacaine in supraclavicular brachial plexus block.