Lidocaine versus ropivacaine for continuous interscalene brachial plexus block after open shoulder surgery

Abstract

Although 1% lidocaine can be effectively used for postoperative patient-controlled interscalene analgesia, 0.2% ropivacaine provides better pain relief and motor function.

Interscalene brachial plexus block for outpatient shoulder arthroplasty: Postoperative analgesia, patient satisfaction and complications

“…Patients undergoing ISB also experience less time in the postanesthesia care unit (PACU)6–8 and importantly, high levels of satisfaction with their anesthesia 79–11. In studies of patients undergoing shoulder surgery procedures, continuous ISB with an infusion of local anesthetic has been shown to have the added advantage of prolonging the period of analgesia after surgery312–14 while decreasing postoperative opioid requirements 13…”

Cervical epidural analgesia via a thoracic approach using nerve‐stimulation guidance in adult patients undergoing total shoulder replacement surgery

“…There may be broader applicability with CEA, as brachial plexus anesthesia often spares C8 and T1 spinal levels while CEA reaches C5–T1/2 and the sensorial portion of the superficial cervical branches (C1–4) (26). Furthermore, brachial plexus anesthesia may not achieve effective separation of motor and sensory block as sensory nerves are in the core bundle, surrounded by motor nerves (27, 28). CEA selectively blocks sympathetic fibres, then sensory fibres, and finally motor fibres with an increasing dose of local anesthetic (29).…”

Postoperative Pain and Other Acute Pain Syndromes

“…Drugs with an intermediate duration of action, such as lidocaine and mepivacaine, 177,178 are commonly used for blocks, whereas long-acting drugs such as ropivacaine, bupivacaine, and levobupivacaine are used mainly for continuous infusion. 179 Some data suggest that bupivacaine and levobupivacaine are more potent than ropivacaine 180,181 ; therefore, the ropivacaine concentration is often increased to compensate. However, ropivacaine, bupivacaine, and levobupivacaine have provided similar analgesic profiles in human trials.…”