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

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.