Open Access Open Access  Restricted Access Subscription Access

Comparision of 0.5% Ropivacaine with 0.5% Bupivacaine for Sciatic Nerve Block in Below Knee Surgeries


Affiliations
1 Department of Anaesthesia, Punjab Institute of Medical Sciences, Jalandhar, Punjab, India
2 Department of Surgery, Punjab Institute of Medical Sciences, Jalandhar, Punjab, India
 

Background and Aim: Sciatic nerve block is very useful in providing surgical anaesthesia and postoperative analgesia for various surgical procedures of the lower leg or foot but due to adverse effect like cardiotoxicity there is lot of research going on to find more cardio stable agent Ropivacaine is commonly tried now a days in place of bupivacaine for sciatic nerve block. We evaluated the comparative efficacy of sciatic nerve block with ropivacaine 5mg/ml and bupivacaine 5mg/ml for below knee surgeries. Material and Methods: Sixty patients of age 18-60 years of American Society of Anesthesiologists (ASA) grade I and II undergoing below knee surgeries under sciatic nerve block were randomly divided into two groups of 30 each in double blind fashion. Group R received 20ml ropivacaine 5mg/ml while Group B: received 20ml bupivacaine 5mg/ml after location of sciatic nerve with peripheral nerve locator. Time of onset of sensory and motor blockade, quality of anaesthesia and analgesia, duration of analgesia and side effects were recorded for each patient. The results were expressed as mean±SD. Statistical analysis consisted of Z test. ANOVA was used to analyze hemodynamic variations between two groups. p<0.05 considered as significant and p<0.01 considered as highly significant. Results: The two groups were comparable with respect of age, sex and weight. The time to onset of sensory, motor block and duration of analgesia was statistically non significant between the two groups though the time of onset of sensory blockade was less with ropivacaine. The quality of anaesthesia and analgesia was found to be adequate and good quality in both the groups. Conclusion: It can be concluded that equivalent doses of ropivacaine and bupivacaine provided sufficient anaesthesia and postoperative analgesia for surgeries below the knee and ropivacaine is a good alternative to bupivacaine for sciatic nerve block if cardiotoxicity is of concern.

Keywords

Bupivacaine, Below Knee Surgeries, Ropivacaine, Sciatic Nerve Block.
User
Notifications
Font Size

  • Watts SA, Sharma DJ. Long-term neurological complications associated with surgery and peripheral nerve blockade: outcomes after 1065 consecutive blocks. Anaesth Intensive Care 2007; 35:24–31. PMid:17323662
  • Klein SM, Nielsen KC, Greengrass RA, et al. Ambulatory discharge after long-acting peripheral nerve blockade: 2382 blocks with ropivacaine. Anesth Analg. 2002; 94:65–70. crossref PMid:11772802
  • McClure JH. Ropivacaine. Br j Anaesth.1996; 76:300–7. crossref PMid:8777115
  • Feldman HS, Covino BG. Comparative systemic toxicity of convulsant and supraconvulsant doses of intravenous ropivacaine, bupvacaine and lidocaine in conscious dogs. Anesth Analg. 1998; 69:794–801
  • Nancarrow C, Rutten AJ, et al. Myocardial and cerebral drug concentration and the mechanisms of death after fatal intravenous doses of lidocaine, bupivacaine and ropivacaine in sheep. Anesth Analg. 1989; 69:276–83. crossref PMid:2774223
  • Scott DB, Lee A, et al. Acute toxicity of ropivacaine compared to bupivacaine. Anesth Analg. 1989; 69:563–9. crossref PMid:2679230
  • Coventry DM. Plasma bupivacaine concentration after inadvertent intravenous injection. Anaesthesia. 1989; 44:162. crossref PMid:2929944
  • Coventry DM, Todd JG. Alkalinisation of bupivacaine for scatic nerve blockade. Anaesthesia. 1989; 44:467–70. crossref
  • Andrea C, Battista B, Guido F, et al. A double blinded randomized comparison of either 0.5% levobupivacaine or 0.5% ropivacaine for sciatic nerve block. Anesth Analg. 2002; 94:987–90. crossref
  • Casati A, Vinciguerra F, Santorsala R, et al. Sciatic nerve block with 0.5% levobupivacaine, 0.75% levobupivacaine or 0.75% ropivavaine: A double blind randomized comparison. European Journal of Anaesthesiology. 2005; 22:452–6. crossref PMid:15991509
  • Conolly C, Coventry DM, Wildsmith JAW. Double blind comparison of ropivacaine 7.5 mg/ml with bupivacaine 5mg/ml for sciatic nerev block. Br J Anaesth. 2001; 86(5):674–7. crossref
  • Kilpatrick AWA, Coventry DM, Todd JG. A comparison of two approaches to sciatic nerve block. Anaesthesia. 1992; 47:155–7.crossref PMid:1539788

Abstract Views: 274

PDF Views: 76




  • Comparision of 0.5% Ropivacaine with 0.5% Bupivacaine for Sciatic Nerve Block in Below Knee Surgeries

Abstract Views: 274  |  PDF Views: 76

Authors

Balwinderjit Singh
Department of Anaesthesia, Punjab Institute of Medical Sciences, Jalandhar, Punjab, India
Angelina K. Rekhi
Department of Anaesthesia, Punjab Institute of Medical Sciences, Jalandhar, Punjab, India
Iqbal Singh
Department of Anaesthesia, Punjab Institute of Medical Sciences, Jalandhar, Punjab, India
Amit Bhardwaj
Department of Anaesthesia, Punjab Institute of Medical Sciences, Jalandhar, Punjab, India
Subhash Goyal
Department of Surgery, Punjab Institute of Medical Sciences, Jalandhar, Punjab, India

Abstract


Background and Aim: Sciatic nerve block is very useful in providing surgical anaesthesia and postoperative analgesia for various surgical procedures of the lower leg or foot but due to adverse effect like cardiotoxicity there is lot of research going on to find more cardio stable agent Ropivacaine is commonly tried now a days in place of bupivacaine for sciatic nerve block. We evaluated the comparative efficacy of sciatic nerve block with ropivacaine 5mg/ml and bupivacaine 5mg/ml for below knee surgeries. Material and Methods: Sixty patients of age 18-60 years of American Society of Anesthesiologists (ASA) grade I and II undergoing below knee surgeries under sciatic nerve block were randomly divided into two groups of 30 each in double blind fashion. Group R received 20ml ropivacaine 5mg/ml while Group B: received 20ml bupivacaine 5mg/ml after location of sciatic nerve with peripheral nerve locator. Time of onset of sensory and motor blockade, quality of anaesthesia and analgesia, duration of analgesia and side effects were recorded for each patient. The results were expressed as mean±SD. Statistical analysis consisted of Z test. ANOVA was used to analyze hemodynamic variations between two groups. p<0.05 considered as significant and p<0.01 considered as highly significant. Results: The two groups were comparable with respect of age, sex and weight. The time to onset of sensory, motor block and duration of analgesia was statistically non significant between the two groups though the time of onset of sensory blockade was less with ropivacaine. The quality of anaesthesia and analgesia was found to be adequate and good quality in both the groups. Conclusion: It can be concluded that equivalent doses of ropivacaine and bupivacaine provided sufficient anaesthesia and postoperative analgesia for surgeries below the knee and ropivacaine is a good alternative to bupivacaine for sciatic nerve block if cardiotoxicity is of concern.

Keywords


Bupivacaine, Below Knee Surgeries, Ropivacaine, Sciatic Nerve Block.

References