Three-in-one blocks with ropivacaine: Evaluation of sensory onset time andquality of sensory block

The purpose of this prospective, randomized, double-blinded study was to ev aluate the sensory onset time and the quality of sensory block of ropivacai ne, a new long-acting local anesthetic, compared with bupivacaine, for 3-in -1 blocks. Fifty ASA physical status I-III patients undergoing hip surgery after trauma were randomly assigned to two study groups of 25 patients each . The two study groups received a 3-in-1 block with either 20 mL of ropivac aine 0.5% or 20 mL of bupivacaine 0.5%. Blocks in both groups were performe d using a nerve stimulator. The sensory onset time and the quality of senso ry block was assessed by pinprick test in the central sensory region of eac h of the three nerves and compared with the same stimulation in the contral ateral leg. We used a scale from 100% (normal sensation) to 0% (no sensory sensation). We did not find significant differences in sensory onset times between the ropivacaine group and the bupivacaine group (30 +/- 11 vs 32 +/ - 10 min). The quality of sensory blocks was also comparable between the st udy groups (19% +/- 20% vs 21% +/- 15%). We conclude that the sensory onset time and quality of sensory block during 3-in-1 blocks performed with ropi vacaine are comparable to those with bupivacaine. Ropivacaine is described as being less potent than bupivacaine, making this local anesthetic promisi ng for 3-in-1 blocks because of its reportedly lower incidence of cardiovas cular and central nervous system complications. Implications: Ropivacaine 0 .5% has a sensory onset time and quality of sensory block during 3-in-1 blo cks similar to that of bupivacaine 0.5%. Ropivacaine is described as being less potent than bupivacaine, making it a promising local anesthetic for 3- in-1 blocks because of its reportedly lower cardiovascular and central nerv ous system toxicity.