Dose-Response Effects of Spinal Neostigmine Added to Bupivacaine Spinal Anesthesia in Volunteers 

1999 ◽  
Vol 90 (3) ◽  
pp. 710-717 ◽  
Author(s):  
Spencer S. Liu ◽  
Peter S. Hodgson ◽  
James M. Moore ◽  
Walter J. Trautman ◽  
Daniel L. Burkhead
Keyword(s):  
Side Effects ◽  
Spinal Anesthesia ◽  
Dose Response ◽  
Small Dose ◽  
Motor Block ◽  
Rank Correlation ◽  
Sensory Block ◽  
Ambulatory Anesthesia ◽  
Respiratory Parameters ◽  
Double Blinded

Background Intrathecal adjuncts often are used to enhance small-dose spinal bupivacaine for ambulatory anesthesia. Neostigmine is a novel spinal analgesic that could be a useful adjunct, but no data exist to assess the effects of neostigmine on small-dose bupivacaine spinal anesthesia. Methods Eighteen volunteers received two bupivacaine spinal anesthetics (7.5 mg) in a randomized, double-blinded, crossover design. Dextrose, 5% (1 ml), was added to one spinal infusion and 6.25, 12.5, or 50 microg neostigmine in dextrose, 5%, was added to the other spinal. Sensory block was assessed with pinprick; by the duration of tolerance to electric stimulation equivalent to surgical incision at the pubis, knee, and ankle; and by the duration of tolerance to thigh tourniquet. Motor block at the quadriceps was assessed with surface electromyography. Side effects (nausea, vomiting, pruritus, and sedation) were noted. Hemodynamic and respiratory parameters were recorded every 5 min. Dose-response relations were assessed with analysis of variance, paired t tests, or Spearman rank correlation. Results The addition of 50 microg neostigmine significantly increased the duration of sensory and motor block and the time until discharge criteria were achieved. The addition of neostigmine produced dose-dependent nausea (33-67%) and vomiting (17-50%). Neostigmine at these doses had no effect on hemodynamic or respiratory parameters. Conclusions The addition of 50 microg neostigmine prolonged the duration of sensory and motor block. However, high incidences of side effects and delayed recovery from anesthesia with the addition of 6.25 to 50 microg neostigmine may limit the clinical use of these doses for outpatient spinal anesthesia.

scholarly journals Intrathecal clonidine added to small-dose bupivacaine prolongs

2013 ◽  
Vol 6 (1) ◽  
pp. 25
Author(s):  
Agreta Gecaj-Gashi ◽  
Hasime Terziqi ◽  
Tune Pervorfi ◽  
Arben Kryeziu
Keyword(s):  
Spinal Anesthesia ◽  
Postoperative Analgesia ◽  
Motor Block ◽  
Sensory Block ◽  
Analgesia Requirement ◽  
American Society ◽  
Group B ◽  
Double Blinded ◽  
Intrathecal Clonidine ◽  
American Society Of Anesthesiologists

Introduction: The aim of this prospective, double-blinded studywas to investigate the effects of clonidine in co-administrationwith bupivacaine during spinal anesthesia, regarding the onset and regression of motor and sensory block, postoperative analgesia and possible side effects.Methods: We randomly selected 66 male patients (age 35 to 70), from the American Society of Anesthesiologists (ASA) class I-II; these patients were scheduled for transurethral surgical procedures. These patients were randomly allocated into two groups of 33 patients each: group B (bupivacaine) only received 0.5% isobaric bupivacaine 7.5 mg intrathecally and group BC (bupivacaine + clonidine) received bupivacaine 7.5 mg and clonidine 25 μg intrathecally. We performed the spinal anesthesia at a level of L3-L4 with a 25-gauge needle. We assessed the sensory block with a pinprick,the motor block using the Bromage scale, analgesia with thevisual analog scale and sedation with the modified Wilson scale.We also recorded the hemodynamic and respiratory parameters.Results: The groups were demographically similar. The mean time of achievement of moto block (Bromage 3) and sensory block at level T9 was significantly shorter in the BC group compared with B group (p = 0.002, p = 0.000, respeectively). The motor block regression time was not significantly different between the two groups (p = 0.237). The postoperative analgesia requirement was significantly longer in group BC compared with group B (p = 0.000). No neurological deficit, sedation or other significant adverse effects were recorded.Conclusion: The intrathecal application of clonidine in combination with bupivacaine improves the duration and quality of spinal anesthesia; it also provides longer duration of postoperative analgesia, without significant side effects.

scholarly journals Perbandingan Efek 10 Mg dengan 12,5 Mg Levobupivacain 0,5% Isobarik terhadap Onset, Durasi, dan Hemodinamik pada Spinal Anestesi untuk Seksio Sesarea

2020 ◽  
Vol 2 (2) ◽  
pp. 71-8
Author(s):  
Rachmad Ismail ◽  
Muh Ramli Ahmad ◽  
A. Muh. Takdir Musba
Keyword(s):  
Data Analysis ◽  
Side Effects ◽  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Motor Block ◽  
Sensory Block ◽  
Hemodynamic Changes ◽  
Group Data ◽  
Significant Difference ◽  
Sensory Motor

Latar Belakang: Tujuan utama spinal anestesi pada seksio sesarea adalah meminimalkan efek samping pada ibu dan bayi baru lahir. Levobupivacain memiliki mekanisme aksi yang sama dengan anestesi lokal lainnya, akan tetapi memiliki efek toksik pada jantung dan saraf yang lebih kecil. Tujuan: Membandingkan onset/durasi blok sensorik, motorik serta hemodinamik antara 10 Mg dengan 12,5 Mg Levobupivacain 0,5% Isobarik + fentanyl 25 μg pada seksio sesarea dengan anestesi spinal.Metode: Sampel terdiri dari dua kelompok, kelompok pertama menerima 10 Mg Levobupivacain 0,5% Isobarik + fentanyl 25 μg dan kelompok kedua menerima 12,5 Mg Levobupivacain 0,5% Isobarik + fentanyl 25 μg dengan sampel masing-masing kelompok 23 orang. Analisis data menggunakan uji statistik uji T independen.Hasil: Onset blok sensorik lebih cepat pada kelompok 12,5 Mg Levobupivacain (2,30 menit) dibandingkan kelompok 10 Mg Levobupivacain (3,70 menit), hal ini secara statistik menunjukkan perbedaan yang signifikan. Durasi blok sensorik kelompok 12,5 Mg Levobupivacain (187,39 menit), durasi blok motorik (194,57 menit) lebih lama dibandingkan kelompok 10 Mg Levobupivacain durasi blok sensorik (153,48 menit) dan durasi blok motorik (157,83 menit). Tidak ada perbedaan yang signifikan pada perubahan hemodinamik untuk kedua kelompokSimpulan: Onset blok sensorik kelompok 12,5 Mg Levobupivacain lebih cepat dibandingkan kelompok 10 Mg Levobupivacain, durasi blok sensorik dan blok motorik kelompok 12,5 Mg Levobupivacain lebih lama dibandingkan kelompok 10 Mg Levobupivacain. Comparison Effects 10 Mg with 12.5 Mg Levobupivacain 0.5% Isobaric Against Onset, Duration, and Hemodynamics in Spinal Anesthesia of Caesarean Section Abstract Background: The main purpose of spinal anesthesia in cesarean section is to minimize side effects on the mother and newborn baby. Levobupivacaine has the same mechanism of action as other local anesthetics, but has a smaller toxic effect on the heart and nerves.Objective: Comparing the onset / duration of sensory, motor and hemodynamic blocks between 10 Mg and 12.5 Mg Levobupivacain 0.5% Isobaric + 25 μg fentanyl in cesarean section with spinal anesthesia.Methods: The sample consisted of two groups, the first group received 10 Mg Levobupivacain 0.5% Isobaric + fentanyl 25 μg and the second group received 12.5 Mg Levobupivacain 0.5% Isobaric + fentanyl 25 μg with a sample of 23 people each group. Data analysis using independent T test statistical tests.Results: Sensory block onset was faster in the 12.5 Mg Levobupivacain group (2.30 minutes) than the 10 Mg Levobupivacain group (3.70 minutes), this statistically showed a significant difference. The sensory block duration of the 12.5 Mg Levobupivacain group (187.39 minutes), the motor block duration (194.57 minutes) is longer than the 10 Mg Levobupivacain group the duration of the sensory block (153.48 minutes) and the duration of the motor block (157.83 minutes). There were no significant differences in hemodynamic changes for the two groups.Conclusion: The onset of the 12.5 Mg Levobupivacain sensory block was faster than the 10 Mg Levobupivacain group, the duration of the sensory block and motor block of the 12.5 Mg Levobupivacain group was longer than the 10 Mg Levobupivacain group

Dose-Response Characteristics of Spinal Bupivacaine in Volunteers

1996 ◽  
Vol 85 (4) ◽  
pp. 729-736 ◽  
Author(s):  
Spencer S. Liu ◽  
Paul D. Ware ◽  
Hugh W. Allen ◽  
Joseph M. Neal ◽  
Julia E. Pollock
Keyword(s):  
Electrical Stimulation ◽  
Spinal Anesthesia ◽  
Dose Response ◽  
Motor Block ◽  
Isometric Force ◽  
Sensory Block ◽  
Transcutaneous Electrical Stimulation ◽  
Response Data ◽  
Linear Regressions ◽  
Selection Of

Background Small doses of bupivacaine may be a reasonable choice for spinal anesthesia for patients having ambulatory surgery. However, few dose-response data are available to guide the selection of reasonable doses of bupivacaine for different ambulatory procedures. Methods Eight volunteers per group were randomized to receive 3.75, 7.5, or 11.25 mg of 0.75% bupivacaine with 8.25% dextrose in a double-blind manner. Sensory block was assessed with pinprick, transcutaneous electrical stimulation equivalent to surgical incision at the ankle, knee, pubis, and umbilicus, and with duration of tolerance to pneumatic thigh tourniquet. Motor block at the quadriceps and gastrocnemius muscles was assessed with isometric force dynamometry. Times until recovery from spinal anesthesia were recorded. Dose-response relationships were determined by linear regressions. Mean (95% confidence intervals) for durations of sensory and motor block per milligram of bupivacaine administered were calculated from linear regressions. Results Significant dose-response relationships (P < 0.006) were determined for sensory block, motor block, and time until recovery (R from 0.6 to 0.9). Within the range of doses studied, each additional milligram of bupivacaine was associated with an increase in duration of tolerance to transcutaneous electrical stimulation of 10 (7 to 13) min, an increase in tolerance to tourniquet of 7 (2 to 11) min, an increase in duration of motor block of 8 (5 to 12) min, and an increase in time until recovery of 21 (17 to 25) min. Conclusions These dose-response data may guide the selection of reasonable doses of bupivacaine for various outpatient procedures, although individual responses vary.

scholarly journals A comparative clinical study of intrathecal hyperbaric bupivacaine with and without fentanyl for hysterectomy

2020 ◽  
Vol 11 (2) ◽  
pp. 59-63
Author(s):  
Hari Poudel ◽  
Surinder Nath Bawa ◽  
Surendra Mohan Sharma
Keyword(s):  
Side Effects ◽  
Spinal Anesthesia ◽  
Sensory Block ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Maximum Height ◽  
Hyperbaric Bupivacaine ◽  
Sensory Blockade ◽  
Group I ◽  
Group Ii

Background: Spinal anaesthesia has been widely used for lower abdominal surgeries like hysterectomy.Hyperbaric bupivacaine is the most extensively used local anesthetic. Addition of fentanyl can allow the reduction in the dose of bupivacaine, increase the height and duration of sensory blockade, and reduces complications of spinal anesthesia. Aims and Objective: The aim of the study was to examine whether adding fentanyl to hyperbaric bupivacaine would increase the height of sensory blockade, accelerate the onset of sensory blockade and increase the duration of the sensory blockade. Material and Methods: This study was done in Manipal Teaching Hospital, Pokhara, Nepal that included hundred patients who underwent total abdominal hysterectomy. The patients were randomly allocated in two groups; Group I: received 0.5% hyperbaric bupivacaine 2.5 ml (12.5 mg) plus normal saline 0.5 ml. Group II: received 0.5% hyperbaric bupivacaine 2.5 ml (12.5 mg) plus 0.5 ml fentanyl (25 μg). Hemodynamic variables, onset of motor and sensory blockade, duration of sensory and motor blockade and any side effects were observed and recorded. Results: The highest and lowest sensory block in Group I was T-7 and T-9 whereas in Group II was T-5 and T-9 respectively. In group I, the mean onset till maximum height of sensory blockade was 7.04 min whereas in group II it was 5.96 min (P<0.00).There was no significant statistical difference in the incidence of side effects in both the groups. Conclusion: Intrathecal fentanyl with hyperbaric bupivacaine for spinal anesthesia significantly accelerated the onset of sensory blockade and increased its maximum height and duration.

Comparison of Three Solutions of Ropivacaine/Fentanyl for Postoperative Patient-controlled Epidural Analgesia 

1999 ◽  
Vol 90 (3) ◽  
pp. 727-733 ◽  
Author(s):  
Spencer S. Liu ◽  
James M. Moore ◽  
Amy M. Luo ◽  
Walter J. Trautman ◽  
Randall L. Carpenter
Keyword(s):  
Side Effects ◽  
Abdominal Surgery ◽  
Epidural Analgesia ◽  
Local Anesthetic ◽  
Motor Block ◽  
Three Solutions ◽  
Primary Determinant ◽  
Blinded Manner ◽  
Anesthetic Solution ◽  
Double Blinded

Background Ropivacaine, 0.2%, is a new local anesthetic approved for epidural analgesia. The addition of 4 microg/ml fentanyl improves analgesia from epidural ropivacaine. Use of a lower concentration of ropivacaine-fentanyl may further improve analgesia or decrease side effects. Methods Thirty patients undergoing lower abdominal surgery were randomized in a double-blinded manner to receive one of three solutions: 0.2% ropivacaine-4 microg fentanyl 0.1% ropivacaine-2 microg fentanyl, or 0.05% ropivacaine-1 microg fentanyl for patient-controlled epidural analgesia after standardized combined epidural and general anesthesia. Patient-controlled epidural analgesia settings and adjustments for the three solutions were standardized to deliver equivalent drug doses. Pain scores (rest, cough, and ambulation), side effects (nausea, pruritus, sedation, motor block, hypotension, and orthostasis), and patient-controlled epidural analgesia consumption were measured for 48 h. Results All three solutions produced equivalent analgesia. Motor block was significantly more common (30 vs. 0%) and more intense with the 0.2% ropivacaine-4 microg fentanyl solution. Other side effects were equivalent between solutions and mild in severity. A significantly smaller volume of 0.2% ropivacaine-4 microg fentanyl solution was used, whereas the 0.1% ropivacaine-2 microg fentanyl group used a significantly greater amount of ropivacaine and fentanyl. Conclusions Lesser concentrations of ropivacaine and fentanyl provide comparable analgesia with less motor block despite the use of similar amounts of ropivacaine and fentanyl. This finding suggests that concentration of local anesthetic solution at low doses is a primary determinant of motor block with patient-controlled epidural analgesia after lower abdominal surgery.

scholarly journals Influence of Positioning on Plain Levobupivacaine Spinal Anesthesia in Cesarean Section

2010 ◽  
Vol 2010 ◽  
pp. 1-4 ◽  
Author(s):  
Fabio Gori ◽  
Francesco Corradetti ◽  
Vittorio Cerotto ◽  
Vito Aldo Peduto
Keyword(s):  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Supine Position ◽  
Motor Block ◽  
Sensory Block ◽  
Sensory Level ◽  
Physical Status ◽  
Gravitational Forces ◽  
Block Level ◽  
Dermatomal Level

Background. The behaviour of isobaric levobupivacaine in relation to gravity when used in obstetric spinal anesthesia is unclear.Methods. 46 women with ASA physical status 1 undergoing cesarean section were randomly allocated to 2 groups. Spinal anesthesia with 12.5 mg levobupivacaine was performed in the sitting position in all women. Those in the first group were placed in the supine position immediately after the injection, while those in the second group were asked to remain seated for 2 minutes before assuming the supine position. The sensory block level, the onset of sensory and motor blocks, the regression of the sensory block for 2 dermatomes of the sensory block, the first request for analgesics, and the regression of motor block were recorded.Results. No differences in onset times, sensory level, or Bromage score were observed between the two groups. The time of first analgesic request was earlier in the seated group (supine131±42 min, seated106±29 min,P=.02).Conclusion. Isobaric levobupivacaine in women at term produces a subarachnoid block the dermatomal level of which does not depend on gravitational forces.

scholarly journals A Comparative Study of Intravenous Clonidine and Dexmedetomidine on Characteristics of Bupivacaine Spinal Anesthesia

2020 ◽  
Vol 5 (1) ◽  
pp. 165-167
Author(s):  
Shailender Bamel ◽  
Nandita Kad ◽  
Vinit ◽  
Shilpa Popli ◽  
Devender Chahal
Keyword(s):  
Single Dose ◽  
Spinal Anesthesia ◽  
Postoperative Analgesia ◽  
Orthopedic Surgery ◽  
Lower Limb ◽  
Motor Block ◽  
Sensory Block ◽  
Well Being ◽  
Control Group ◽  
Sensory Blockade

Background: Spinal anesthesia with bupivacaine is administered routinely for lower abdominal and lower limb surgeries. The ensuing nerve block is sufficient to ensure patient’s well being, while motor block facilitates the surgeon’s work. In patients receiving spinal anaesthesia, with local anesthetic agents like bupivacaine, the addition of another drug as adjuvant prolongs the analgesia. The present study is designed to study the effect of dexmedetomidine (D) and Clonidine (C) on the duration of motor and sensory block as well as postoperative analgesia by intrathecal bupivacaine in patients undergoing lower limb orthopedic surgery. Subjects and Methods: This study was carried out on 90 patients in the age group of 18 to 50 years, belonging to the American Society of Anesthesiologists(ASA) physical status I and II presenting for lower limb orthopedic surgery were included in the study. Patients were divided randomly into 3 groups. Group D received 1μg kg-1of dexmedetomidine, group C received 2 μg kg-1 of clonidine and group NS Control group received an equivalent amount of normal saline. Results: From the current study we observed that single dose of 1 μg kg-1 dexmedetomidine over 20 minutes started 20 minutes after spinal block and a single dose of 2 μg kg-1 Clonidine resulted in a significant prolongation of time to two-segment regression, postoperative analgesia,  sensory block and motor block with the maintenance of hemodynamic parameters. Intravenous dexmedetomidine was more effective than Clonidine at the prolongation of time to two-segment regression, postoperative analgesia, sensory block and motor block of spinal anesthesia with 0.5% hyperbaric bupivacaine. Conclusion:  Dexmedetomidine (1μg kg-1) in comparison to Clonidine (2 μg kg-1) and placebo is far more effective in the motor blockade, sensory blockade and duration of postoperative analgesia.

scholarly journals A PROSPECTIVE RANDOMISED COMPARITIVE DOUBLE BLIND STUDY TO DETERMINE THE DURATION OF ANALGESIA OF BUPRENORPHINE AND DEXAMETHASONE AS ADJUNCTS TO BUPIVACAINE IN SCIATICO-POPLITEAL AND SAPHENOUS NERVE BLOCK FOR BELOW KNEE SURGERIES.

2020 ◽  
pp. 1-3
Author(s):  
Renjith I ◽  
Renu Devaprasath ◽  
Geo Navin Jude ◽  
T. S. Ambujam
Keyword(s):  
Side Effects ◽  
Nerve Block ◽  
Normal Saline ◽  
Motor Block ◽  
Sensory Block ◽  
Saphenous Nerve ◽  
Double Blind Study ◽  
Double Blind ◽  
The Mean ◽  
Mean Time

BACKGROUND: Adjuvants to local anaesthetics improve the block properties and reduce opioid consumption. This study compared combination of local anaesthetic bupivacaine with buprenorphine and dexamethasone in ultrasound guided sciatico-popliteal and saphenous nerve block for below knee surgeries. STUDY DESIGN:A prospective, double-blind, randomized, comparative study. MATERIAL AND METHODS: 82 patients posted for elective or emergency below knee surgeries were randomly divided into 2 groups. Group X received 25ml block solution made up of 2mg/kg of 0.5% bupivacaine with 2mcg/kg buprenorphine and normal saline and group Y received 25ml block solution made of 2mg/kg of 0.5% bupivacaine with 0.1mg/kg dexamethasone and normal saline. Onset of sensory block, onset of motor block, duration of analgesia, hemodynamic parameters, and side effects were noted in each group. RESULTS: The mean time of onset of sensory block was earlier in group X (6.730±1.871 min) as compared to group Y (11.340±3.038min). The mean time of onset of motor block was also rapid in group X (9.000±2.121 min) than in group Y (13.020±2.286min). The mean total duration of analgesia was longer in group Y (1098.000±169.216) as compared to group X (794.070±145.084). There was no signicant difference in the mean duration of motor block between the groups. Both the groups were hemodynamically stable, and no signicant side effects were noted. CONCLUSIONS: Onset of sensory and motor blockade was faster in the buprenorphine group, however duration of analgesia was much longer in the dexamethasone group without any signicant side effects.

scholarly journals Comparison of effects of Bupivacaine and Ropivacaine in patients undergoing elective Caesarean section

2020 ◽  
Vol 4 (3) ◽  
pp. 859-863
Author(s):  
Sangeeta Subba ◽  
Arjun Arjun Chhetri ◽  
Rupak Bhattarai
Keyword(s):  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Motor Block ◽  
Elective Caesarean Section ◽  
Sensory Block ◽  
Elective Cesarean Section ◽  
Hyperbaric Bupivacaine ◽  
Safe Alternative ◽  
Elective Cesarean ◽  
Group B

Introduction: Spinal anesthesia is considered a reasonable choice for cesarean section. Bupivacaine and ropivacaine have been used as intrathecal drugs alone or in combination with various opioids. Ropivacaine is considered a valid and safe alternative to bupivacaine for spinal anesthesia. Objectives: To compare the efficacy and safety of hyperbaric ropivacaine with hyperbaric bupivacaine in spinal anesthesia for elective cesarean section. Methodology: Sixty pregnant women undergoing elective cesarean section were allocated into two groups. Group R received 3 ml of 0.5% hyperbaric ropivacaine (2 ml 0.75% plain ropivacaine mixed with 1 ml of 25 %dextrose) and Group B received 2.5 ml of 0.5% hyperbaric bupivacaine. Both the groups were compared in terms of onset of sensory and motor block, regression of sensory and motor block, duration of analgesia and side effects. Results: The onset of sensory block was comparable in both groups but was statistically insignificant. The onset of motor block in Bupivacaine(7.53 ± 1.72) min was faster when compared to Ropivacaine group(14.33 ± 6.19) min. Regression of sensory and motor block both were faster in Ropivacaine group. Duration of analgesia was longer in Bupivacaine group(131.17 ± 32.95)min than Ropivacaine group(125.33 ± 30.54)min. Conclusion: Ropivacaine can be used as an alternative to Bupivacaine for spinal anesthesia in cesarean section but has a shorter duration of sensory and motor block.

The Study of Effectiveness of Ropivacaine in Axillary Brachial Plexus Block for Forearm Surgery

2020 ◽  
Vol 22 (4) ◽  
pp. 248-253
Author(s):  
Sulav Acharya ◽  
GR Bajracharya ◽  
S Gauchan ◽  
N Dhakal
Keyword(s):  
Side Effects ◽  
Brachial Plexus ◽  
Analgesic Effect ◽  
Motor Block ◽  
Brachial Plexus Block ◽  
Onset Time ◽  
Sensory Block ◽  
Axillary Brachial Plexus Block ◽  
The Mean ◽  
Plexus Block

Brachial plexus block is a suitable alternative to general anaesthesia for patient undergoing upper extremity surgery. Ropivacaine the S-enantiomer emerged as a possible replacement of Bupivacaine without undesirable toxic effects.Therefore this study was conducted to assess the block characteristics and side effects of 0.75% ropivacaine in axillary brachial plexus block for forearm surgeries. This interventional study was carried out in 30 patients of ASA physical status I or II, aged 18 to 60 yrs undergoing elective surgery u nder axillary brachial plexus block with 20 ml of 0.75 % Ropivacaine using ultrasound and nerve stimulator. The mean onset time of sensory block was 4.53 ± 1.18 minutes and duration of sensory block was 491.00 ± 57.45 minutes. The mean onset time of motor block was 9.17 ± 1.39 minutes and duration of motor block was 452.50 ± 52.34 minutes. The mean time for rescue analgesia or total analgesic effect was 569.47 ± 88.46 minutes. No patients developed any side effects. The result of this study concluded that Ropivacaine is a safe drug providing longer duration of sensory analgesic effect and early recovery of motor function with good operating conditions for forearm surgeries under brachial blexus block.

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