Comparison of 0.5% Ropivacaine and 0.5% Bupivacaine in Supraclavicular Brachial Plexus Block for Upper Limb Surgeries: A Randomized Comparative Study

Background: Supraclavicular brachial plexus block is a commonly used regional anesthesia technique for upper limb surgeries. Bupivacaine and ropivacaine, both long-acting amide local anesthetics, are widely employed, but their relative efficacy and safety profiles remain an area of clinical interest. The present study was conducted to compare the onset, duration of sensory and motor block, duration of postoperative analgesia, and safety of 0.5% ropivacaine versus 0.5% bupivacaine in supraclavicular brachial plexus block for upper limb surgeries. Methods: A prospective, randomized, comparative study was conducted on 60 patients (ASA I–II), aged 18–60 years, undergoing elective upper limb surgeries. Patients were randomly allocated into two groups: Group R (ropivacaine 0.5%, n=30) and Group B (bupivacaine 0.5%, n=30). Sensory and motor block characteristics, duration of analgesia, hemodynamic parameters, and adverse effects were recorded and statistically analyzed. Results: Demographic characteristics were comparable between groups (p > 0.05). The onset of sensory (7.8 ± 1.5 min vs. 9.2 ± 1.8 min, p=0.002) and motor block (10.6 ± 1.9 min vs. 12.4 ± 2.1 min, p=0.001) was significantly faster with bupivacaine. The duration of sensory (495.8 ± 52.4 min vs. 410.5 ± 45.2 min, p<0.001) and motor block (462.3 ± 48.6 min vs. 375.6 ± 40.8 min, p<0.001) was significantly longer in the bupivacaine group. The duration of effective analgesia was also prolonged with bupivacaine (520.7 ± 55.3 min vs. 430.2 ± 48.6 min, p<0.001). Hemodynamic parameters remained stable in both groups. Adverse effects such as hypotension, bradycardia, and sedation were minimal and comparable between groups, with no major complications. Conclusion: Both 0.5% ropivacaine and 0.5% bupivacaine are effective for supraclavicular brachial plexus block. However, bupivacaine provides a faster onset and longer duration of sensory and motor block, as well as prolonged postoperative analgesia, with a comparable safety profile to ropivacaine.