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REGIONAL ANESTHESIA AND PAIN MEDICINE

A Comparison of Ropivacaine and Bupivacaine for Cervical Plexus Block

Ariane Junca, MD^*, Emmanuel Marret, MD^*, Georges Goursot, MD, Xavier Mazoit, MD, PhD, and Francis Bonnet, MD^*

*Service d’Anesthésie-Réanimation, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris; Hôpital Saint-Michel, Paris; and Laboratoire d’Anesthésie, Université de Paris Sud, Faculté de Médecine, Le Kremlin Bicêtre, France

Address correspondence and reprint requests to Francis Bonnet, Service d’Anesthésie, Hôpital Tenon, 4 rue de la Chine, 75970 Paris CEDEX. Address e-mail to francis.bonnet{at}tnn.ap-hop-paris.fr

We compared bupivacaine 0.5% and ropivacaine 0.75% for cervical plexus block (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 anesthetic solutions. We evaluated the onset of anesthetic block; the requirement for supplementation during the surgery; the patients’ satisfaction; postoperative 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 immediately 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, and satisfaction scores. In the Bupivacaine group, visual analog scale scores 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 peak concentrations was comparable (5 [1–15 min] vs 5 [0–45 min] in the Ropivacaine and Bupivacaine groups, respectively). We conclude that ropivacaine has no advantage over bupivacaine for CB.

Implications: Compared with bupivacaine (150 mg), a larger dose of ropivacaine (225 mg) produces comparable features of cervical plexus block but less postoperative analgesia and larger plasma concentrations. There is no reason to favor ropivacaine in such a case.

This article has been cited by other articles:

				J. J. Pandit, R. Satya-Krishna, and P. Gration Superficial or deep cervical plexus block for carotid endarterectomy: a systematic review of complications Br. J. Anaesth., August 1, 2007; 99(2): 159 - 169. [Abstract] [Full Text] [PDF]

				S. Aunac, M. Carlier, F. Singelyn, and M. De Kock The Analgesic Efficacy of Bilateral Combined Superficial and Deep Cervical Plexus Block Administered Before Thyroid Surgery Under General Anesthesia Anesth. Analg., September 1, 2002; 95(3): 746 - 750. [Abstract] [Full Text] [PDF]

Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999