Introduction: Femur fractures are very painful. The peripheral nerve block provides good analgesia in these patients before performing regional anesthesia. This study aims to compare 2 local anesthestics in femoral nerve block for analgesia in preoperative positioning and postoperative analgesia of patients Methods: Prospective, randomized study was conducted on 60 patients (18-60 years) of ASA I&II scheduled for femur surgery under combined spinal epidural. anaesthesia In group B (n=30), femoral nerve block(FNB) was performed with 0.2% bupivacaine (30ml) and in group R(n=30), 0.2% ropivacaine (30 ml) was used. Various parameters like numeric rating pain scale, time to spinal anaesthesia, sensory and motor block onset times and durations, time to first analgesic use, intraoperative & postoperative visual analog scale (VAS) data, post-operative epidural top ups, vitals and side effects were recorded for each patient. Results: Pain assessed on visual analogue scale (VAS) during positioning was significantly less in FNB group using 0.2%bupivacaine at 5 minutes. Time to perform spinal block was significantly shorter in FNB group using 0.2% bupivacaine (8.30 min) versus ropivacaine group (17.30 min). But postoperative analgesic requirements were more in ropivacaine group and duration of analgesia was prolonged in bupivacaine group. Conclusion: With bupivacaine time to perform spinal anesthesia was reduced and postoperative analgesia was better with bupivacaine group.

The aim of the study is to evaluate the effect of transversus abdominis plane block on chronic postoperative pain after inguinal hernia repair. Methods: Prospective randomized double blinded study is conducted on 40 male patients posted for inguinal hernia repair under spinal anaesthesia. Divided into 2 equal groups. Group I received USG TAP block with 20 ml of 0.25% bupivacaine whereas Group II received 20 ml of normal saline (Placebo) at the end of surgery. Postoperative VAS scores, analgesic consumption, DN4 scoring at 3 and 6 months to evaluate chronic pain were studied. Results: Forty male patients were enrolled. Postoperative VAS scores of Group I had improved scores than Group II. Analgesic consumption is also reduced in Group I compared to Group II (156.6  48.3 vs 282.1  43.2) which was statistically significant. Incidence of neuropathic pain in Group II was 5% at 3 months and 10% at 6 months; whereas in Group I one patient scored '3' at 3 months which reduced to '2' at 6 months. No restriction of daily activities present in Group I patient. Conclusion: USG TAP block provided better postoperative VAS scores and analgesic consumption, along with the reduction in incidence of chronic pain than placebo.

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Introduction: Peripheral nerve blocks have become important in clinical practice because of their role in post-operative pain relief, shortening of patient recovery time & avoiding risks and adverse effects of general anaesthesia. Bupivacaine is a long acting local anaesthetic. Due to its long duration of action and combined with its high quality sensory blockade compared to motor blockade it has been the most commonly used local anaesthetic for peripheral nerve blocks. Ropivacaine is a newer, long acting local anaesthetic whose neuronal blocking potential used in peripheral nerve blockade seems to be equal or superior to bupivacaine. Method of collection of data: Sixty patients aged between 18 years and 60 years, of physical status ASA grade 2 and ASA grade 3 undergoing elective upper limb surgeries lasting more than 30 minutes were included in the study after getting ethical clearance. Each patient was randomly allocated to one of the two groups of 30 patients each. The patients were explained about the procedure and premedicated with tab alprazolam 0.5mg, and tab ranitidine 150 mg. The anesthetic technique employed was supraclavicular brachial plexus block using 30 ml of either 0.5% bupivacaine or 0.5% ropivacaine. Results: In our study, we observed that onset time of sensory block was earlier in bupivacaine group in comparison with ropivacaine group. Onset time of motor block was earlier in bupivacaine group in comparison with ropivacaine group having a mean value of 22.90±1.88 minutes which is statistically significant. Duration of sensory block was 362.00±47.66 minutes with bupivacaine group and 322.00±42.38 minutes with ropivacaine group. The duration of sensory block was longer in bupivaine group compared with ropivacaine group. The duration of motor block was 399.00±41.05 minutes with bupivacaine group and 366.00±37.29 minutes with ropivacaine group. The duration of motor block was longer in bupivaine group compared with ropivacaine group. The duration of analgesia was 402.00±42.86 minutes with bupivacaine group (Group B) and 371.00±36.52 minutes with ropivacaine group (Group R) in our study. Conclusion: On the basis of our study, we can draw the conclusion that at equal volumes bupivacaine 0.5% has an advantage over ropivacaine 0.5% for supraclavicular brachial plexus block in terms of early onset of sensory blockade, early onset of motor blockade, prolonged duration of sensory blockade, prolonged duration of motor blockade, prolonged duration of analgesia.