A Randomised Trial Comparing Block Characteristics of a Mixture Versus Sequential Injections of Lignocaine and Ropivacaine for Supraclavicular Brachial Plexus Nerve Block in Patients Undergoing Upper Limb Surgery

Dr Sweta Mahapatra, Dr Sucheta Pattanayak

Abstract: Background: The optimal method for combining local anaesthetic (LA) agents for peripheral nerve blocks remains unclear. This study evaluated whether administering lignocaine and ropivacaine as a combined solution differs from giving the two drugs sequentially, with respect to block performance during ultrasound-guided supraclavicular brachial plexus anaesthesia for upper-limb surgeries. Methods: In this double-blind randomised clinical trial, 64 adult patients planned for upper-limb surgery were allocated to receive either a 1: 1 mixture of 2% lignocaine with adrenaline and 0.75% ropivacaine (Mixed group, M) or separate sequential injections of the same solutions (Sequential group, S), with 15 mL of each drug. The primary outcome was the proportion of patients achieving complete sensory block of all four major nerves at 10 minutes. Secondary outcomes included onset profiles of sensory and motor block up to 30 minutes, overall duration of block, analgesia duration, and any complications. Results: Baseline characteristics were comparable in both groups. At 10 minutes, a significantly larger proportion of patients in Group S achieved complete sensory block (69%) compared with Group M (41%). Sensory and motor block characteristics equalised by 30 minutes. Total duration of analgesia, sensory block, and motor block did not differ between groups. No serious complications occurred. Conclusion: Sequential administration of lignocaine followed by ropivacaine provides a faster early onset of sensory and motor block compared with mixing both agents, although the overall duration of block remains similar with both techniques.

Keywords: Local Anaesthesia, Lignocaine, Brachial Plexus, Ropivacaine, Supraclavicular brachial plexus block

How to Cite?: Dr Sweta Mahapatra, Dr Sucheta Pattanayak, "A Randomised Trial Comparing Block Characteristics of a Mixture Versus Sequential Injections of Lignocaine and Ropivacaine for Supraclavicular Brachial Plexus Nerve Block in Patients Undergoing Upper Limb Surgery", Volume 14 Issue 12, December 2025, International Journal of Science and Research (IJSR), Pages: 44-46, https://www.ijsr.net/getabstract.php?paperid=MR251201084657, DOI: https://dx.doi.org/10.21275/MR251201084657