• Tomoki Nishiyama.
• Department of Anesthesiology and Critical Care, Higashi Omiya General Hospital, 5-18, Higashi Omiya, Minuma-ku, Saitamashi, Saitama 337-0051, Japan. nishit-tky@umin.ac.jp
• Med Arh. 2012 Jan 1;66(5):315-7.

IntroductionThe effects of ropivacaine and bupivacaine in interscalene block have been studied, but we usually combine lidocaine with ropivacaine or bupivacaine to fasten the onset. However, the effects of these combinations are not studied.PurposeTo compare the effects of two different concentrations of the combination of ropivacaine or bupivacaine with lidocaine.Materials And MethodsOne hundred adult patients scheduled for repair of fracture of the upper extremity under interscalene block were randomly allocated into one of the groups receiving the combination of 15 mL of ropivacaine 0.375% (Ropivacaine 0.375 group), ropivacaine 0.75% (Ropivacaine 0.75 group), bupivacaine 0.25% (Bupivacaine 0.25 group), or bupivacaine 0.5% (Bupivacaine 0.5 group) with lidocaine 1.0% 15 mL. The onset and duration of motor and sensory blocks were compared among the 4 groups by Kruskal Wallis test followed by Mann-Whitney U test.ResultsThree patients in the Ropivacaine 0.375 group did not show any motor blocks. Ropivacaine groups had significantly slower onset of motor block and longer duration of motor and sensory blocks than Bupivacaine groups. Bupivacaine 0.5 group had significantly longer duration of both blocks than Bupivacaine 0.25 group, while Ropivacaine 0.375 and 0.75 groups had the similar duration of both blocks.ConclusionsIn interscalene block combined with lidocaine, ropivacaine had slower onset of motor block and longer duration of both blocks than bupivacaine. Only bupivacaine showed the different duration of the blocks between two concentrations.

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