Comparative study of ropivacaine and lidocaine for intravenous regional anaesthesia for hand and forearm surgeries

ABSTRACT

Intravenous regional anesthesia [IVRA] is a useful and reliable technique for limbs surgeries. Lidocaine, the most common used local anesthetic has a short duration of action. So searching for new longer acting and safe drug aiming at increasing popularity of IVRA. The aim of this study was to compare ropivacaine and lidocaine as regards the duration and quality of intra- and postoperative analgesia. This study was carried out on 20 patients. They were divided into 2 equal groups group I received 40 ml of lidocaine 0.5% for IVRA, group II received 40 ml of Ropivacaine 0.2%. Assessments of intraoperative analgesia were obtained at 5 min. interval. The onset time of analgesia was recorded. Postoperative analgesia, decreased pin prick sensation, decreased grip strength times were recorded. The tolerance times for the proximal and distal tourniquets were recorded. Systemic side effects were rated. No significant difference was observed for onset of times of anesthesia, quality of intraoperative analgesia and tolerance time for the proximal tourniquet between the two groups. The tolerance time for the distal tourniquet was significantly longer in the Ropivacaine group [45 +/- 3 min] than lidocaine group [31 +/- 7 min]. Postoperative analgesia, decreased pin prick sensation and decreased grip strength times were significantly prolonged in the ropivacaine group. As regard CNS and other side effects, there was no significant difference between the two groups. Based on these finding. Ropivacaine offers advantages over lidocaine for IVRA. It provided good quality of intraoperative analgesia, prolonged distal tourniquet tolerance time and prolonged postoperative analgesia