Comparative study of 0.5% ropivacaine and 0.5% bupivacaine for brachial plexus block by supraclavicular approach for upper limb surgeries

Shailendra Modak, Shakuntala Basantwani


Background: Present study was undertaken to evaluate the clinical efficacy of 0.5% ropivacaine for supraclavicular bronchial plexus block for upper limb surgeries and comparing it with 0.5% bupivacaine in terms of characteristics of supraclavicular blockade and side effects. 

Methods: The design was a prospective double blind randomized study enrolling 60 patients of either sex, ASA I and II, were randomly allocated into two groups in which supraclavicular brachial plexus block was performed with nerve stimulator using 30 ml of ropivacaine 0.5% and bupivacaine 0.5% respectively. The onset and duration of sensory and motor block and possible adverse events were recorded.

Results: Ropivacaine had earlier onset of sensory and motor blockade compared to bupivacaine. The duration of sensory and motor blockade was longer in group of patients treated with ropivacaine than in bupivacaine group. No statistically significant difference was found in quality of blocks in both groups. There were no adverse effects observed in the study.

Conclusions: Ropivacaine 0.5% can be safely used as an alternative to bupivacaine 0.5% in supraclavicular bronchial plexus block.


Ropivacaine, Bupivacaine, Supraclavicular brachial plexus block, Sensory and motor blockade

Full Text:



Hall RJ. Hydrochlorate of cocaine. NY Med J. 1884;40:643-46.

Brown DL, Cahill DR, Bridenbaugh LD. Supraclavicular nerve block: anatomic analysis of a method to prevent pneumothorax. Anesth Analg. 1993;76:530-4.

Khanduri KC. Regi onal anaesthetic techniques for orthopaedic surgeries. Med J Armed Forces India. 2008;64:109.

Eeckelaert JP, Filliers E, Alleman JJ, Hanegreefs G. Supraclavicular brachial plexus block with the aid of a nerve stimulator. Acta Anaesthesiol Belg.1984;35:5-17.

Albright GA. Cardiac arrest following regional anesthesia with etidocaine or bupivacaine. Anesthesiology.1979;51:285-7.

Akerman B, Helberg IB, Trossvik C. Primary evaluation of the local anaesthetic properties of amino amide agent ropivacaine (LEA 103). Acta Anaesthesiol Scand. 1988;32:571-8.

Hickey R, Candido KD, Rammurthy S, Winnie AP, Blanchard J, Raza SM, et al. Brachial plexus block with a new local anaesthetic 0.5% ropivacaine. Can J Anaesth. 1990;37:732-8.

Klein SM, Greengrass RA, Steel SM. A comparison of 0.5% bupivacaine, 0.5% ropivacaine and 0.75% ropivacaine for interscelene brachial plexus block. Anesthesia Analgesia. 1998;87:1316-91.

Hickey R, Hoffman J, Ramaaurthy S, A comparison of ropivacaine 0.5% and bupivacaine 0.5% for brachial plexus block. Anesthesiology. 1991;74:639-42.

Vainionppa VA, Haavisto E, Huita TM. A clinical and pharamacokinetic comparison of ropivacaine and bupivacaine in axillary plexus block, Anesthesia Analgesia. 1995;81:534-8.

Meglade DP, Kalpokas MV, Mooney PH. A comparison of 0.5% ropivacaine and 0.5% bupivacaine for axillary brachial plexus anesthesia. Anesthesia Intensive Care. 1998;26:515-20.

Bertini L, Manuni S, Tanganello V. 0.75% and 0.5% ropivacaine axillary brachial plexus block; A clinical comparison with 0.5% bupivacaine, Regional Anesthesia Pain med 1999;24:514-8.

Casati A, Fanelli G, Aldegheri G, Barti M. Interscelene brachial plexus anesthesia with 0.5%, 0.75%, 1% ropivacaine: double blind comparison with 2% mepivacaine. Br J Anesthesia. 1999;83:872-5.

Ana A, Pena R, Guadalupe Z, Lemus, Beatriz V, Victoria G. Clinical comparison of bupivacaine and ropivacaine for neurostimulation-guided brachial plexus block by axillary approach; Mexicana De Anetesiologia. 2009;32(1):7-13.

Hickey R, Rowley CL, Winnie AP, S. A comparison of ropivacaine 0.25% and bupivacaine 0.25% for brachial plexus block. Anesthesia Analgesia. 1992;75:602-6.

Vaghadia H, Chan V, Ganpathy S. A multicentric trial of ropivacaine 7.5 mp/ml vs bupivacaine 5 mg/ml for supracavicular brachial plexus anesthesia. Anesthesia Canadian J Anesthesia. 1999;46(10):946-51.

Casati A, Fanelli G, Albertin A, Deni F. Interscelene brachial plexus anesthesia with either 0.5% ropivacaine or 0.5% bupivacaine. Minerva Anesthesiol. 2000;66(1):39-44.

Ahmet E, Halil U. A clinical comparison of equal concentration and volume of ropivacaine and bupivacaine interscelene brachial plexus anesthesia for shoulder surgery. Regional Anesthesia Pain Med. 2004;29(6):539-43.