Comparative Study of Ropivacaine 0.75% and Levobupivacaine 0.5% in Ultrasound-Guided Axillary Plexus Block for Elective Upper Limb Surgeries

Background: Axillary plexus block is a common technique for upper limb surgeries, providing adequate analgesia and muscle relaxation. Ropivacaine and levobupivacaine are widely used local anaesthetics, with differences in onset time, duration of the block, and postoperative analgesia. Aim and Objective: To compare the efficacy of ropivacaine with 0.75% and levobupivacaine with 0.5% in ultrasound-guided axillary plexus block. This comparison is crucial for understanding the differences in onset time, duration of the block, and postoperative analgesia between these two widely used local anaesthetics. Materials and Methods: This prospective, randomized, double-blind clinical trial was conducted at SVBP Hospital, affiliated with LLRM Medical College, Meerut, involving 80 patients aged 18-65 with ASA physical status I and II. Patients were randomly assigned to Group A (Ropivacaine 0.75%, 25 ml) and Group B (Levobupivacaine 0.5%, 25 ml). The primary outcomes included the onset and duration of sensory and motor blocks. Secondary outcomes were postoperative analgesia, hemodynamic parameters, and complications. Data were analyzed using SPSS version 20.0, with a p-value of <0.05 considered statistically significant. Results: The mean onset time for sensory block was significantly faster in Group A (7.92 ± 1.01 min) compared to Group B (10.35 ± 1.17 min, p = 0.011). Similarly, motor block onset was faster in Group A (9.10 ± 0.87 min) than in Group B (11.27 ± 1.11 min, p = 0.005). The duration of the sensory block was shorter in Group A (9.21 ± 0.87 hrs) compared to Group B (12.25 ± 1.20 hrs, p = 0.032). Motor block duration was also shorter in Group A (8.54 ± 0.87 hrs) than in Group B (11.41 ± 1.17 hrs, p = 0.023). Postoperative analgesia lasted longer in Group B (12.93 ± 1.08 hrs) compared to Group A (9.93 ± 0.86 hrs, p = 0.038). Two patients in Group A experienced nausea and vomiting, while no complications were observed in Group B. Conclusion: Ropivacaine 0.75% provides a faster onset of sensory and motor blocks, while Levobupivacaine 0.5% offers a longer duration of both blocks and postoperative analgesia. Both agents were well-tolerated, with minimal complications. The choice between these two anaesthetics should be guided by the clinical scenario, depending on whether a faster onset or longer duration of block is required.