0.5% levobupivacaine versus 0.5% ropivacaine: Are they different in ultrasound-guided sciatic block?

Abstract

Context and Aims:Little is known about onset and duration of sciatic block after 0.5% levobupivacaine (Levo) versus 0.5% ropivacaine (Ropi) for ultrasound-guided technique. We assessed these parameters in the ultrasound-guided block, to know for the practice.Setting and Design:A comparative randomized double-blind study was conducted in the University Hospital.Materials and Methods:Were included 35 adults of ASA I-II, scheduled for foot surgery, presenting clear imaging of their sciatic nerve at mid-thigh. A volume of 20 mL of either 0.5% Levo or 0.5% Ropi were injected around the sciatic nerve at mid-thigh using ultrasound guidance (out of the plane) followed by placement of a catheter to use, if necessary, for perioperative analgesia. A femoral single shot block was systematically performed to block the saphenous nerve. The onset times until complete foot block (primary outcome) and the sensory and motor block duration (secondary outcome) were assessed using Wilcoxon test. Values were expressed as medians (1st-3rd quartile).Results:Except for two delayed sciatic blocks in each group, the onset time otherwise was 35 min (20-60) in Ropi versus 40 min (30-60) in Levo, P = 0.5. Sensory block lasted longer in Levo, 17 h (14-27) compared with 15 h (10-17) in Ropi, P = 0.04. No significant between-group difference was found with motor block durations, 15 h (12-18) in Levo and 15 h (12-16) in Ropi, P = 0.3.Conclusion:No difference of onset times was found in ultrasound-guided sciatic block whether using Levo or Ropi. Levo induced a longer-lasting sensory block.

Volume of ropivacaine 0.2% and common peroneal nerve block duration: a randomised, double‐blind cohort trial in healthy volunteers

“…Large variations in nerve block duration have been reported previously . The common belief that simply administering more LA will ensure prolonged block duration may not be true, and identifying factors that could decrease this variation is important.…”

“…The minimal relevant effective difference in nerve block duration was considered to be 3 h. Mean (SD) sensory block duration for 5 ml of ropivacaine 0.2% was assumed to be 14 (2.5) h . We estimated the dropout rate to be one subject per trial group.…”

Comparative evaluation of ropivacaine and levobupivacaine for postoperative analgesia after ultrasound-guided paravertebral block in patients undergoing percutaneous nephrolithotomy

“…[ 5 ] Ropivacaine (RB) and levobupivacaine (LB) are enantiomers of bupivacaine that have been compared extensively when administered in neuraxial blocks or other peripheral nerve blocks. [ 6 7 8 ] The present study was undertaken to ascertain the relative analgesic efficacy of these two local anesthetic agents in patients scheduled to undergo PCNL receiving ultrasound-guided PVB.…”

Postoperative analgesia comparing levobupivacaine and ropivacaine for brachial plexus block

“…[5] Studies comparing postoperative analgesia in sciatic nerve block showed that levobupivacaine had a longer duration of postoperative analgesia compared with ropivacaine. [12–14] There are four previous studies comparing levobupivacaine and ropivacaine in the same concentrations used for brachial plexus blocks. However, 3 of the studies of brachial plexus block report no difference between these 2 agents.…”