A clinical comparison of vertical infraclavicular brachial plexus block using 0.75% or 0.5% ropivacaine for upper limb surgery

Abstract

Background: We performed a prospective, double blind study to compare the clinical effect of vertical infraclavicular brachial plexus block produced by 0.75% vs 0.5% ropivacaine for upper limb surgery.Methods: We included 80 patients receiving upper limb surgery under infraclavicular brachial plexus block. The infraclavicular brachial plexus block was performed via the vertical technique with 30 ml of 0.75% or 0.5% ropivacaine. By observation, we determined nerve type was stimulated and scored the level of sensory block and motor block. The quality of blocks was assessed intra-operatively. The duration of sensory block and motor block and their complications were assessed.Results: There were no significant differences in the frequency of stimulated nerve type, evolution of sensory and motor block quality, or success of block. There were no significant differences in the duration of sensory block and motor block. Vascular puncture was noted in 1 patient in the 0.75% ropivacaine.Conclusions: Both the 0.75% and 0.5% ropivacaine had similar effects in the vertical infraclavicular brachial plexus block.

Effects of increasing the dose of ropivacaine on vertical infraclavicular block using neurostimulation

“…In our institution, we routinely use 30 ml of local anesthetics and 0.5% ropivacaine for the infraclavicular block. In our previous study [ 6 ], the same volume (30 ml) of 0.75% and 0.5% ropivacaine produced similar infraclavicular block success rates and efficacy. Our hypothesis is that a further increase in the dose of local anesthetics (to the recommended maximum [ 7 ]) by volume (40 ml of 0.5% ropivacaine) or volume/concentration (40 ml of 0.75% ropivacaine) will yield a higher infraclavicular block success rate using neurostimulation.…”

“…The success rates of our previous studies were 70-88% [ 6 , 8 , 9 ]. In this study, we hypothesize that increasing the dose of local anesthetics will enhance the infraclavicular block success rate and efficacy.…”