A Comparative Study of 0.5% Bupivacaine vs 0.75% Ropivacaine for Analgesic Efficacy under Supraclavicular Brachial Plexus Block

Background The supraclavicular brachial plexus block is a widely used regional anaesthesia technique for upper limb surgeries, offering superior perioperative analgesia and minimizing systemic anaesthetic exposure. Bupivacaine and Ropivacaine are long-acting local anaesthetics commonly used in this technique, with Ropivacaine gaining interest for its improved safety profile. Objective To compare the onset, duration, and quality of analgesia between 0.5 Bupivacaine and 0.75 Ropivacaine in supraclavicular brachial plexus block using a peripheral nerve stimulator. Methods This prospective, randomized, double-blind clinical study involved 100 ASA grade III patients undergoing elective upper limb surgery. Participants were allocated into two equal groups Group B (0.5 Bupivacaine, 30 mL) and Group R (0.75 Ropivacaine, 30 mL). Blocks were administered using the nerve stimulator-guided supraclavicular approach. The primary outcomes assessed were onset and duration of sensory and motor block, and total duration of analgesia. Secondary outcomes included haemodynamic stability and adverse events. Results Ropivacaine demonstrated a faster onset of sensory and motor block with a shorter duration of motor blockade, while providing comparable analgesic efficacy to Bupivacaine. Both agents maintained stable haemodynamic parameters. No significant adverse events were reported. Conclusion Ropivacaine 0.75 is a clinically effective and safer alternative to 0.5 Bupivacaine for supraclavicular brachial plexus block, offering comparable analgesia with faster recovery of motor function, making it particularly suitable for ambulatory surgeries.