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Comparative study of different concentrations of prilocaine and ropivacaine for intraoperative axillary brachial plexus block

Published online by Cambridge University Press:  01 March 2006

M. Freitag ,
K. Zbieranek ,
A. Gottschalk ,
M. Bubenheim ,
R. Winter ,
S. Tuszynski  and
T. G. Standl
M. Freitag
Affiliation:
University Medical Centre Hamburg, Department of Anaesthesiology, Hamburg, Germany
K. Zbieranek
Affiliation:
University Medical Centre Hamburg, Department of Anaesthesiology, Hamburg, Germany
A. Gottschalk
Affiliation:
University Medical Centre Hamburg, Department of Anaesthesiology, Hamburg, Germany
M. Bubenheim
Affiliation:
University Medical Centre Hamburg, Institute for Medical Biometry and Epidemiology, Hamburg, Germany
R. Winter
Affiliation:
University Medical Centre Hamburg, Department of Anaesthesiology, Hamburg, Germany
S. Tuszynski
Affiliation:
University Medical Centre Hamburg, Department of Anaesthesiology, Hamburg, Germany
T. G. Standl
Affiliation:
Academic Hospital Solingen, Department of Anaesthesia and Intensive Care Medicine, Germany
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Summary

Background and objective: To compare the anaesthetic characteristics in terms of onset and offset times of the sensory and motor blocks of prilocaine 1% and ropivacaine 0.75% alone and in different combinations when used for brachial plexus anaesthesia in axillary perivascular blocks. Methods: After informed consent 96 ASA I–III patients undergoing forearm or hand surgery participated in this prospective, randomized, double-blind study. Patients received either prilocaine 1% 40 mL (G1), prilocaine 1% 30 mL and ropivacaine 0.75% 10 mL (G2), prilocaine 1% 20 mL and ropivacaine 0.75% 20 mL (G3) or ropivacaine 0.75% 40 mL (G4) for axillary perivascular brachial plexus anaesthesia. Onset and duration of sensory and motor blocks in the distribution of the musculocutaneous, radial, median and ulnar nerves were assessed. Results: The onset time of the sensory and motor blocks of the whole brachial plexus differed only between patients in G4 with ropivacaine 0.75% 40 mL demonstrating a later motor onset in comparison to all other groups and a later sensory onset in comparison to G1 and G2 (P < 0.01). The addition of ropivacaine resulted in longer offset times of the sensory and motor blocks. The median offset time of the motor block was 179.5 min in G1, 262 min in G2, 389.5 min in G3 and 745 min in G4 (P < 0.01). The median offset time of the sensory block was 163.5 min in G1, 277 min in G2, 383.5 min in G3 and 784 min in G4 (P < 0.01). There was no difference in onset and offset times between sensory and motor blocks within the groups. Conclusions: For axillary perivascular brachial plexus block prilocaine 1% alone and in combination with ropivacaine 0.75% was similar in terms of onset of sensory and motor blocks but different in duration of sensory and motor blocks without a differential sensory and motor offset.

Keywords

ANAESTHETICS LOCAL, prilocaine, ropivacaineANAESTHESIA, conductionBRACHIAL PLEXUS, axillary block
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 23 , Issue 6 , June 2006 , pp. 481 - 486
Copyright
© 2006 European Society of Anaesthesiology

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References

Knudsen K, Suurkula BM, Blomberg S, Sjovall J, Edvardsson N. Central nervous and cardiovascular effects of i.v. infusions of ropivacaine, bupivacaine and placebo in volunteers. Br J Anaesth 1997; 78: 507–514.Google Scholar
Scott DB, Lee A, Fagan D, Bowler GM, Bloomfield P, Lundh R. Acute toxicity of ropivacaine compared with that of bupivacaine. Anesth Analg 1989; 69: 563–569.Google Scholar
Hickey R, Candido KD, Ramamurthy S et al. Brachial plexus block with a new local anaesthetic: 0.5 per cent ropivacaine. Can J Anaesth 1990; 37: 732–738.Google Scholar
Vaghadia H, Chan V, Ganapathy S et al. A multicentre trial of ropivacaine 7.5 mg mL−1 vs. bupivacaine 5 mg mL−1 for supra clavicular brachial plexus anesthesia. Can J Anaesth 1999; 46: 946–951.Google Scholar
Klein SM, Greengrass RA, Steele SM et al. A comparison of 0.5% bupivacaine, 0.5% ropivacaine, and 0.75% ropivacaine for interscalene brachial plexus block. Anesth Analg 1998; 87: 1316–1319.Google Scholar
Bertini L, Tagariello V, Mancini S et al. 0.75% and 0.5% ropivacaine for axillary brachial plexus block: a clinical comparison with 0.5% bupivacaine. Reg Anesth Pain Med 1999; 24: 514–518.Google Scholar
McGlade DP, Kalpokas MV, Mooney PH et al. A comparison of 0.5% ropivacaine and 0.5% bupivacaine for axillary brachial plexus anaesthesia. Anaesth Intens Care 1998; 26: 515–520.Google Scholar
Raeder JC, Drosdahl S, Klaastad O et al. Axillary brachial plexus block with ropivacaine 7.5 mg kg−1: a comparative study with bupivacaine 5 mg kg−1. Acta Anaesthesiol Scand 1999; 43: 794–798.Google Scholar
Vainionpaa VA, Haavisto ET, Huha TM et al. A clinical and pharmacokinetic comparison of ropivacaine and bupivacaine in axillary plexus block. Anesth Analg 1995; 81: 534–538.Google Scholar
Dunlop DJ, Graham CM, Watt JM. The practical use of axillary brachial plexus block for hand surgery. J Hand Surg 1995; 20: 677–678.Google Scholar
Tryba M, Borner P. Clinical effectiveness and systemic toxicity of various mixtures of prilocaine and bupivacaine in axillary plexus block. Reg Anesth 1988; 11: 40–49.Google Scholar
Holm S. A simple sequentially rejective multiple test procedure. Scand J Statist 1979; 6: 65–70.Google Scholar
Zaric D, Nydahl PA, Philipson L et al. The effect of continuous lumbar epidural of ropivacaine (0.1%, 0.2%, and 0.3%) and 0.25% bupivacaine on sensory and motor block in volunteers: a double-blind study. Reg Anesth 1996; 21: 14–25.Google Scholar
Janzen PR, Vipond AJ, Bush DJ, Hopkins PM. A comparison of 1% prilocaine with 0.5% ropivacaine for outpatient-based surgery under axillary brachial plexus block. Anesth Analg 2001; 93: 187–191.Google Scholar
Schroeder LE, Horlocker TT, Schroeder DR. The efficacy of axillary block for surgical procedures about the elbow. Anesth Analg 1996; 83: 747–751.Google Scholar
Moore DC, Bridenbaugh LD, Bridenbaugh PO, Tucker GT. Bupivacaine for peripheral nerve block: a comparison with mepivacaine, lidocaine, and tetracaine. Anesthesiology 1970; 32: 460–463.Google Scholar
Neal JM, Hebl JR, Gerancher JC, Hogan QH. Brachial plexus anesthesia: essentials of our current understanding. Reg Anesth Pain Med 2002; 27: 402–428.Google Scholar
Casati A, Fanelli G, Cappelleri G et al. A clinical comparison of ropivacaine 0.75%, ropivacaine 1% or bupivacaine 0.5% for interscalene brachial plexus anaesthesia. Eur J Anaesthesiol 1999; 16: 784–789.Google Scholar
Zaric D, Axelsson K, Nydahl PA et al. Sensory and motor blockade during epidural analgesia with 1%, 0.75%, and 0.5% ropivacaine: a double-blind study. Anesth Analg 1991; 72: 509–515.Google Scholar
Spiegel DA, Dexter F, Warner DS, Baker MT, Todd MM. Central nervous system toxicity of local anesthetic mixtures in the rat. Anesth Analg 1992; 75: 922–928.Google Scholar