EP069 Comparison of analgesic efficacy of bupivacaine and ropivacaine in ultrasound guided interscalene block in shoulder scopy surgeries – a prospective, randomised, double blinded study

<h3>Background and Aims</h3> Shoulder arthroscopy procedure is a popular diagnostic and therapeutic tool in shoulder injuries. Interscalene block provides adequate analgesia as shoulder gets its major innervation through suprascapular, lateral pectoral, axillary nerves, which can be easily blocked at the level of roots. Our aim is to compare the efficacy of 0.25% bupivacaine and 0.2% ropivacaine in the ultrasound guided interscalene block (C5,C6,C7) in shoulder scopy surgeries in terms of duration of analgesia and opioid requirement in the first 24 hrs postoperative period. <h3>Methods</h3> After obtaining institutional ethics committee approval and written informed consent, we included 60 patients belonging to ASA PS 1 and 2, anaesthesia was induced with propofol 2 mg/kg, analgesia with fentanyl 2µg/kg , neuromuscular blockade with rocuronium 1 mg/kg, trachea intubated and maintained with oxygen, nitrous oxide and sevoflurane with MAC of 1.5. Then patient in bupivacaine group received ultrasound guided interscalene block using 12 ml 0.25% bupivacaine with 10µg dexmedetomidine, whereas patient in Ropivacaine group received 12 mL 0.2% ropivacaine with 10µg dexmedetomidine . Haemodynamic parameters were noted every 15 min throughout the procedure. Intravenous paracetamol 1 g was given at the end of procedure. After extubation and shifting to postoperative period, analgesia was assessed using VAS score at 0 hr, 6 hr, 12 hr, 24 hr. Fentanyl 1µg/kg was given when the VAS score was more than 4, the time to first analgesic request and the total fentanyl dose given in the 24 hours were noted. <h3>Results</h3> We observed that mean duration of the analgesia was 636.4±212.4 minutes (mean±SD) in bupivacaine group when compared to 715.9±261.6 minutes in ropivacaine group (p=0.27) and the total analgesic requirement was not more than 2µg/kg fentanyl in the first 24 hrs postoperative period in both the groups. <h3>Conclusions</h3> We concluded that there is no statistically significant difference in the duration of analgesia between bupivacaine and ropivacaine group and both provide effective analgesia for shoulder scopy surgeries.