Clinical Evaluation of Ropivacaine versus Ropivacaine with Lignocaine and Adrenaline in Supraclavicular Brachial Plexus Block: a Randomised Double Blind Study

Introduction: Lignocaine with adrenaline is used with local anaesthetics to improve the onset and increase the duration of nerve block. The present study aimed to evaluate it's effect when used together with ropivacaine. Objective: To evaluate the effect of adding 2% lignocaine with adrenaline to 0.5% ropivacaine, for supraclavicular brachial plexus blockade on the onset and duration of sensory and motor block, duration of analgesia and effect on hemodynamic parameters. Material and method: In a prospective randomized double blind study done in Department of Anaesthesia, Himalayan Hospital, supraclavicular brachial plexus blockade by the use of nerve stimulator was performed in 50 patients using 20ml ropivacaine 0.75%. Group A had 10ml of distilled water and Group B had 10 ml of 2% lignocaine with adrenaline (1:200,000), so that final concentration of both groups was 30ml 0f 0.5% ropivacaine. Sensory function was tested using pinprick method, motor function by modified bromage scale, sedation by sedation score and analgesia by VAS score. Results: The lignocaine group showed an earlier onset of motor and sensory block by about 4.88 minutes which was much denser in nature. There was no change in duration of block and analgesia as compared with the control group. No side effects were noted. Conclusion: The addition of 2% lignocaine with adrenaline to ropivacaine 0.5%, for brachial plexus blockade, provides an earlier onset of block, with no effect on the duration of block and analgesia.