Author(s): Gilakala Varaha Ganesh1, Saroj Patta2, Krishna Chaitanya Bevara3
BACKGROUND: Intra Venous Regional Anesthesia (IVRA) is technically straight forward and doesn’t require specific anatomical knowledge. The potential use of a local anesthetic that could provide anesthesia of greater duration than lidocaine with less toxicity than bupivacaine prompted the need for comparison of ropivacaine and lidocaine for IVRA in healthy volunteers and thus the need for the study. A 0.2% solution is to be used because it is the commercially available concentration of ropivacaine for IVRA. Aim of the study was to study and compare the efficacy of 0.5% lignocaine and 0.2% ropivacaine in Intra venous regional analgesia.
METHODS: 60 Patients being electively operated on upper limb, below elbow were enrolled into the study. Patients were divided into two groups. Group L-30 patients were to receive 40ml of 0.5% Lignocaine and Group R- 30 patients were to receive 40ml of 0.2% Ropivacaine. Double tourniquets set up was connected to pneumatic pump with pressure gauge placed over it. The proximal cuff was inflated to 100mm Hg higher than the systolic BP and the bandage was removed. Onset of action of the anaesthetic, intensity of motor blockade, intensity of analgesia, duration of analgesia and complications arising were noted.
RESULTS: Onset of analgesia was immediate with Lignocaine (3-5 minutes) whereas it took 7-10 minutes in patients given Ropivacaine. The quality of analgesia with regards to VAS was better in patients receiving Ropivacaine than those who received Lignocaine. Degree of motor block was grade 0 in 86% patients in Ropivacaine group as compared to 76% in patients of Lignocaine group. Duration of post-operative analgesia was found to be in the range of 3-8 minutes with Ropivacaine group whereas duration with Lignocaine was found to be dependent on the time of tourniquet release. Pain reappeared almost immediately in the Lignocaine group compared to the Ropivacaine group. No side- effects or complications with either of the drugs were noticed.
CONCLUSION: Ropivacaine appears to be a better alternative to Lignocaine with regards to the onset of analgesia, quality of analgesia, degree of motor blockade and post-operative analgesia.