Ropivacaine is a better alternative to lidocaine in intra-venous regional anesthesia

Aims & Objectives: This study was conducted to study the analgesic efficacy of ropivacaine and compare it with that of Lidocaine in intravenous regional anesthesia. Methodology: Fifty patients of physical status ASA I and II, aged 20-50 years undergoing ambulatory hand surgery were randomly allocated to two equal groups of 25 each. Patients in either group received either 40 ml of 0.5% lidocaine or 40 ml of 0.2% ropivacaine. Results: The onset, duration and recovery times of sensory and motor block,time to the request for first analgesic, incidence of rescue medication and total analgesic consumption in first 24 hours were recorded. The recovery time of sen sory block was significantly prolonged but the onset of sensory block was delayed in Ropivacaine Group as compared to patients in Lidocaine Group. Time to the request for first analgesic was significantly prolonged while the incidence of rescue medication and total analgesic consumption was significantly low in patients receiving ropivacaine. No statistically significant difference was found in onset and duration of motor block between the two groups.

[1]  J. Chelly.  Peripheral nerve blocks , 2015 .

[2]  P. Khanna,et al.  Adjuvants for intravenous regional anaesthesia , 2010, Journal of Anaesthesiology Clinical Pharmacology.

[3]  M. Stojanovic,et al.  Does the addition of ketorolac and dexamethasone to lidocaine intravenous regional anesthesia improve postoperative analgesia and tourniquet tolerance for ambulatory hand surgery? , 2008, Minerva anestesiologica.

[4]  Z. Bigat,et al.  Does Dexamethasone Improve the Quality of Intravenous Regional Anesthesia and Analgesia? A Randomized, Controlled Clinical Study , 2006, Anesthesia and analgesia.

[5]  G. Keating,et al.  Ropivacaine , 2012, Drugs.

[6]  P. Atanassoff,et al.  Central nervous system side effects are less important afteriv regional anesthesia with ropivacaine 0.2% compared to lidocaine 0.5% in volunteers , 2002, Canadian journal of anaesthesia = Journal canadien d'anesthesie.

[7]  T. Halaszynski,et al.  Ropivacaine 0.2% and Lidocaine 0.5% for Intravenous Regional Anesthesia in Outpatient Surgery , 2001, Anesthesiology.

[8]  P. Kam,et al.  The arterial tourniquet: pathophysiological consequences and anaesthetic implications , 2001, Anaesthesia.

[9]  V. Chan,et al.  Comparison of ropivacaine and lidocaine for intravenous regional anesthesia in volunteers: a preliminary study on anesthetic efficacy and blood level. , 1999, Anesthesiology.

[10]  C. Alm,et al.  Metabolism of ropivacaine in humans is mediated by CYP1A2 and to a minor extent by CYP3A4: An interaction study with fluvoxamine and ketoconazole as in vivo inhibitors , 1998, Clinical pharmacology and therapeutics.

[11]  K.,et al.  Central nervous and cardiovascular effects of i.v. infusions of ropivacaine, bupivacaine and placebo in volunteers. , 1997, British journal of anaesthesia.

[12]  G. Johansson,et al.  Cardiotoxicity of ropivacaine – a new amide local anaesthetic agent , 1989, Acta anaesthesiologica Scandinavica.

[13]  A. Henderson.  Adverse reaction to bupivacaine: complication of intravenous regional analgesia. , 1980, British medical journal.

[14]  G A Albright,et al.  Cardiac arrest following regional anesthesia with etidocaine or bupivacaine. , 1979, Anesthesiology.

[15]  Ware Rj.  Intravenous regional analgesia using bupivacaine. A double blind comparison with lignocaine. , 1979 .

[16]  R. Ware.  Intravenous regional analgesia using bupivacaine , 1975, Anaesthesia.

[17]  E. Colbern.  The Bier Block for Intravenous Regional Anesthesia: Technic and Literature Review , 1970, Anesthesia and analgesia.