Abstract
ROPIVACAINE 0.75%, LIDOCAINE 1%, OR COMBINATION IN INTERSCALENE BLOCK FOR UPPER EXTREMITY SURGERY

*Tomoki Nishiyama MD, PhD

ABSTRACT

It is a common practice to mix fast onset and long acting local anesthetics in brachial plexus block. However, whether the combination induce fast onset and long duration of the block is still controversial. The present study was performed to clarify whether adding lidocaine to ropivacaine shortens onset time and keeps duration of interscalene block or not. Sixty patients aged 20 to 70 years with ASA physical status I or II for surgery of upper extremity were involved in the study. Interscalene block was performed with 1% lidocaine 30 ml (Lidocaine group, 20 patients), 0.75% ropivacaine 30 ml (Ropivacaine group, 20 patients), or 1% lidocaine 15 ml + 0.75% ropivacaine 15 ml (Combination group, 20 patients). Onset time and duration of the block were measured with loss of pain sensation at surgical field (sensory onset time) and loss of finger movement (motor onset time). Side effects such as convulsion, arrhythmia, nausea, vomit, hypotension, and bradycardia were checked until 12 hour after surgery. The Ropivacaine group had significantly slower onset in both sensory and motor blocks than other two groups. The duration of sensory and motor block of the Lidocaine group was significantly shorter than other two groups. Number of patients with side effects were not different among the groups. In conclusion, in interscalene block, combination of 1% lidocaine 15 mL and 0.75% ropivacaine 15 mL induced faster onset of the block than 0.75% ropivacaine 30 mL, and longer duration of the block than 1% lidocaine 30 mL, without increasing side effects.

Keywords: Interscalene block, lidocaine, ropivacaine, onset time, block duration.


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