A Randomized Controlled Study of  0.5% Bupivacaine, 0.5% Ropivacaine  and 0.75% Ropivacaine for  Supraclavicular Brachial Plexus Block

Venkatesh, Ranjan R; Kumar, P Sateesh; Trissur, Ramachandran R; George, Sagiev Koshy

doi:10.7860/jcdr/2016/22672.9021

Cited by 13 publications

(21 citation statements)

References 12 publications

(4 reference statements)

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“…31 However, comparative studies of cardiovascular safety have reported that these 2 anesthetic agents have similar efficacy and incidences of cardiotoxicity. 16,38 There were no cardiovascular adverse effects in our study.…”

Section: Discussionmentioning

confidence: 48%

Does Combining a Suprascapular Nerve Block With an Intra-articular Corticosteroid Injection Have an Additive Effect in the Treatment of Adhesive Capsulitis? A Comparison of Functional Outcomes After Short-term and Minimum 1-Year Follow-up

Jung

Lee

Min

et al. 2019

Orthopaedic Journal of Sports Medicine

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Background: No therapeutic intervention is universally accepted as the most effective treatment for adhesive capsulitis. An intra-articular corticosteroid injection (IAI) with a suprascapular nerve block (SSNB), a common treatment for this disease, is a safe and effective method for the resolution of pain and restoration of shoulder range of motion (ROM). Purpose: To compare the efficacy of combined SSNB and IAI with that of IAI alone in the treatment of adhesive capsulitis. Study Design: Cohort study; Level of evidence, 3. Methods: We performed a retrospective review of 102 patients with adhesive capsulitis who were treated at an outpatient clinic from July 2016 to January 2017. A combined SSNB with IAI was performed in 48 patients (SSNB + IAI group), and an IAI alone was performed in 54 patients (IAI group). Patients were assessed before the intervention and at 2 weeks and 2 months after the intervention. ROM and pain and function visual analog scales (PVAS and FVAS, respectively), the American Shoulder and Elbow Surgeons (ASES) score, the Korean Shoulder Scoring System (KSS), the Constant score, the Simple Shoulder Test (SST), and the Shoulder Pain and Disability Index (SPADI) were used for clinical assessments. PVAS, FVAS, and ASES scores at a minimum of 1 year after the intervention were assessed for 82 patients. Results: At the 2-month assessment, all parameters significantly improved in both the SSNB + IAI and IAI groups ( P < .05), however, improvements in forward flexion (FF) and abduction (ABD) between the 2-week and 2-month assessments were better in the SSNB + IAI group. At the 2-month assessment, improvements in the FVAS, ASES, SST, and SPADI scores and FF and ABD values were statistically significantly greater in the SSNB + IAI group compared with the IAI group. Improvements in FVAS and ASES scores were significantly greater in the SSNB + IAI group at a minimum of 1 year. Conclusion: Both a combined SSNB and IAI and an IAI alone significantly improved pain and functional outcomes in patients with adhesive capsulitis. The use of an SSNB with an IAI further increased treatment efficacy, as per the FVAS, ASES, SST, and SPADI scores and FF and ABD values. Patients who underwent SSNB combined with an IAI showed better improvements in the FVAS and ASES scores compared with IAI alone at a minimum of 1 year after the intervention. Therefore, an SSNB combined with an IAI may be a good treatment choice for adhesive capsulitis.

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Section: Discussionmentioning

confidence: 48%

Does Combining a Suprascapular Nerve Block With an Intra-articular Corticosteroid Injection Have an Additive Effect in the Treatment of Adhesive Capsulitis? A Comparison of Functional Outcomes After Short-term and Minimum 1-Year Follow-up

Jung

Lee

Min

et al. 2019

Orthopaedic Journal of Sports Medicine

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“…Compared with bupivacaine and levobupivacaine, the lower lipid solubility of ropivacaine provides greater sensory and motor blockade and prompt motor functions recover faster. [ 3 – 6 ] It has been considered effective in local anesthetic and beneficial for postoperative analgesia when ropivacaine is used alone. But the duration of sensory block is still not sufficient to provide long time analgesia and avoid the postoperative use of opioids.…”

Section: Introductionmentioning

confidence: 99%

The effect and safety of dexmedetomidine added to ropivacaine in brachial plexus block

Dai

Tang

2018

Medicine

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Background:Dexmedetomidine has been used as an adjuvanty added to local anesthetics to prolong analgesia following peripheral nerve blockade. The aim of this meta-analysis was to investigate the effect and safety of dexmedetomidine added to ropivacaine in brachial plexus block (BPB).Methods:A search strategy was created to identify eligible randomized clinical trial (RCT) in PubMed, Embase, and The Cochrane Library (updated May, 2018). The methodologic quality for each included study was evaluated using the Cochrane Tool for Risk of Bias by 2 independent researchers.Results:Twelve RCTs were included in the meta-analysis (n = 671). As an adjuvant to ropivacaine, dexmedetomidine significantly reduced the onset time of sensory (mean difference [MD], −3.86 minutes, 95% CI −5.45 to −2.27 minutes; I2 = 85%) and motor (MD, −5.21 minutes; 95% CI −7.48 to −2.94 minutes; I2 = 94%). In addition, it increased the blockade duration of sensory (MD, 228.70 minutes; 95% CI 187.87–269.52 minutes; I2 = 93%) and motor (MD, 191.70 minutes; 95% CI 152.48–230.91 minutes; I2 = 92%). Moreover, the combination prolonged the duration of analgesia (MD, 303.04 minutes; 95% CI 228.84–377.24 minutes; I2 = 86%). There was no difference of the incidence of bradycardia (risk difference [RD], 0.01, 95% CI −0.02 to 0.05, I2 = 45%; P = .45) and hypotension (RD, 0.01, 95% CI −0.01 to 0.03, I2 = 0%; P = .57) between 2 groups.Conclusion:Dexmedetomidine added to ropivacaine in BPB has a better analgesia effect (shorter onset time and longer duration) compared to ropivacaine alone. At the same time, there was no difference in the incidence of bradycardia and hypotension.

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“…dexmedetomidine is equally effective as compared to perineural dexmedetomidine with respect to onset and duration of block and duration of analgesia but has greater hemodynamic instability. Venkatesh RR et al [10] investigated and compared the effectiveness of supraclavicular brachial plexus anaesthesia with two different concentrations of ropivacaine (0.5% and 0.75%) and to compare them with the standard 0.5% bupivacaine. Ninety patients of age 18 to 60 years belonging to American Society of Anaesthesiologists (ASA) status 1 or 2, admitted to Pondicherry Institute of Medical Sciences were chosen for the study and were divided into three groups.…”

Section: Discussionmentioning

confidence: 99%

A prospective observational study to compare the effectiveness of bupivacaine versus levobupivacaine in supraclavicular brachial plexus block

Santosh¹,

Sharma²,

Gogna³

2021

Int. J. Med. Anesthesiology

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Background: Dexmedetomidine produces manageable hypotension and bradycardia, but the striking feature of this drug is the lack of opioid-related side effects such as respiratory depression, pruritus, nausea and vomiting. Addition of dexmedetomidine to local anaesthetic drugs during peripheral nerve blocks may also prove beneficial for surgical patients. Hence, the present study was performed to compare the effectiveness of bupivacaine and levobupivacaine for supraclavicular brachial plexus block in upper limb surgeries. Materials and Methods: The present study was conducted in the Department of Anesthesia of MGM Medical College, Navi Mumbai. The ethical clearance for the study was approved from the ethical committee of the hospital. The study was conducted on 100 patients of ASA I & II status in the age group of 18-60 years given brachial plexus block by supraclavicular approach for various upper limb surgeries, after receiving institutional ethics committee approval. Results: Levobupivacaine had a faster onset & longer duration of both sensory and motor blockade as compared to racemic bupivacaine. The hemodynamic profile of both drugs was similar and no adverse effect was found with either drug. Conclusion:We conclude that in peripheral nerve blocks where large volumes of local anaesthetic is required, levobupivacaine could be a suitable choice as it is known to have less toxic potential.

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A Randomized Controlled Study of 0.5% Bupivacaine, 0.5% Ropivacaine and 0.75% Ropivacaine for Supraclavicular Brachial Plexus Block

Cited by 13 publications

References 12 publications

Does Combining a Suprascapular Nerve Block With an Intra-articular Corticosteroid Injection Have an Additive Effect in the Treatment of Adhesive Capsulitis? A Comparison of Functional Outcomes After Short-term and Minimum 1-Year Follow-up

Does Combining a Suprascapular Nerve Block With an Intra-articular Corticosteroid Injection Have an Additive Effect in the Treatment of Adhesive Capsulitis? A Comparison of Functional Outcomes After Short-term and Minimum 1-Year Follow-up

The effect and safety of dexmedetomidine added to ropivacaine in brachial plexus block

A prospective observational study to compare the effectiveness of bupivacaine versus levobupivacaine in supraclavicular brachial plexus block

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