Comparative Study between Efficacies of Different Concentration of Ropivacaine (0.75% Vs 0.5%) In USG Guided Supraclavicular Brachial Plexus Block In Upper Limb Surgeries

Abstract

Background: Regional anaesthesia using brachial plexus block is widely preferred for upper limb surgeries, with ultrasound guidance improving accuracy and safety. Ropivacaine, a long-acting amide local anaesthetic with reduced cardiotoxicity compared to bupivacaine, provides differential sensory and motor blockade depending on concentration. Determining the optimal concentration for effective block with minimal motor impairment and toxicity is clinically important. The aim of this study was to evaluate the efficacy of different concentrations of ropivacaine, (0.5% and 0.75%) in supraclavicular brachial plexus block in upper limb surgeries.

Material and Methods A prospective, blinded randomized study was conducted, enrolling 64 patients of either sex, American Society of Anesthesiologists (ASA) I and II, who were allocated into two groups in which supraclavicular brachial plexus block was performed using ropivacaine in concentrations of 0.5% and 0.75%, respectively. The onset and duration of sensory and motor blocks were recorded.

Results: The sensory and motor blockade onset and duration was longer in patients who received ropivacaine 0.75%, in comparison to patients who received ropivacaine 0.5%. The time to first rescue analgesia was longer with Ropivacaine 0.75% (12.27 ± 2.34 hours vs. 9.32 ± 1.17 hours; p = 0.001). Both the concentration of Ropivacaine maintained stable haemodynamics, with no major adverse effects reported.

Conclusion: The results suggest that 0.5% ropivacaine is optimal for most routine upper limb surgeries, reserving 0.75% for longer procedures or when extended analgesia is desired. Both concentrations were well-tolerated without any significant complications.