Comparative Study of Anesthetic Efficacy of 0.2% Ropivacaine Alone and 0.2% Ropivacaine with Fentanyl 50 μg in Intravenous Regional Anesthesia

Background: Ropivacaine for intravenous regional anesthesia (IVRA) provides prolonged analgesia over lidocaine and have a lower toxicity compared with bupivacaine. To reduce the amount of local anesthetic and to improve the quality of the block additives like opioids are used. Aim: The present study was designed to assess the anesthetic efficacy and post-tourniquet analgesia of adding fentanyl with ropivacaine for IVRA. Materials and Methods: A total of 50 patients undergoing hand surgery were randomized to receive IVRA with 40 ml of either ropivacaine 0.2% (Group 1, n = 25) or ropivacaine 0.2% with fentanyl 50 μg (Group 2, n = 25). The anesthetic efficacy regarding, onset of sensory block, onset of motor block, and duration of post-tourniquet analgesia were noted and compared. Results: In this study, the sensory block onset time was lesser in ropivacaine plus fentanyl group (6.24 ± 1.714 min) when compared to ropivacaine group (7.88 ± 1.363 min). The onset time of motor block also more in ropivacaine group (11.8 ± 1.825 min) when compared to ropivacaine with fentanyl group (9.88 ± 1.691 min). The duration of post-tourniquet analgesia was higher in ropivacaine plus fentanyl group (137.52 ± 24.036 min) when compared to ropivacaine group (120.76 ± 20.755 min). Conclusion: Ropivacaine 0.2% with fentanyl 50 μg in IVRA has good anesthetic efficacy, lengthened post-tourniquet analgesia, and less incidence of intraoperative tourniquet pain when compared to ropivacaine 0.2% alone.