A comparison of ropivacaine and bupivacaine for cervical plexus block

We compared bupivacaine 0.5% and ropivacaine 0.75% for cervical plexus bloc k (CB). Forty patients scheduled for carotid artery surgery were allocated randomly to undergo superficial and deep CB with 30 mL of one of the two an esthetic solutions. We evaluated the onset of anesthetic block; the require ment for supplementation during the surgery; the patients' satisfaction; po stoperative pain on a visual analog scale at 1, 2, and 3 h; and the use of paracetamol as a rescue analgesic medication. Arterial blood was sampled im mediately and 1, 3, 5, 10, 15, 30, 45, and 60 min after CB for measurements of bupivacaine or ropivacaine concentrations. Patients in both groups had equivalent onset of CB, local infiltration with lidocaine during surgery, a nd satisfaction scores. In the Bupivacaine group, visual analog scale score s were lower at 2 and 3 h, and the delay before paracetamol administration was prolonged. Observed peak concentrations were larger in the Ropivacaine group (4.25 [2.07-6.59 mg/L] vs 3.02 [0.98-5.82 mg/L]), but time to reach p eak concentrations was comparable (5 [1-15 min] vs 5 [0-45 min] in the Ropi vacaine and Bupivacaine groups, respectively). We conclude that ropivacaine has no advantage over bupivacaine for CB.