ABSTRACT
Ropivacaine and levobupivacaine are less cardiovascular and central nervous system toxic, being an alternative to bupivacaine. Butorphanol, an opioid significantly prolongs the duration of the local anaesthetics. Methods: A comparative, Prospective, Randomized, Clinical study was conducted in 60 patients of either sex of ASA I,II ,with age group 18-60 years undergoing upper limb orthopaedic surgeries under USG guided Supraclavicular Brachial Plexus block. Patients were randomly allocated to Group L: 30ml 0.5% Levobupivacaine+600 mcg Butorphanol. Group R: 30ml 0.5% Ropivacaine with 600mcg Butorphanol. Block characteristics were compared as a primary outcome. The data were analyzed with Student-t test. Results: Heart rate, Mean BP, Onset and duration of sensory and motor blockade, Post-op VAS score(every 1 hour for 16hours) were compared intraoperative as well as in the postoperative period. Demographic and hemodynamic data were comparable. All hemodynamic parameters compared were insignificant (P>0.5%).The onset of sensory and motor was significantly earlier in GROUP L (P =0.0048, P=0.002) compared to GROUP R. The duration of sensory and motor block was significantly higher in GROUP L (P=0.00073, P=0.00021). Group R required rescue analgesic earlier than Group L. Conclusion: Though both are long acting and safer than bupivacaine, Levobupivacaine is better than ropivacaine in terms of early onset of sensory-motor blockade and prolonged duration of sensory-motor blockade. Butorphanol augments the efficacy of local anesthetics without any untoward side effects.