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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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