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Original Article
- Trauma
- Comparison of ropivacaine, bupivacaine, and lignocaine in femoral nerve block to position fracture femur patients for central neuraxial blockade in Indian population
- Manik Seth, Santvana Kohli, Madhu Dayal, Arin Choudhury
- Acute Crit Care. 2024;39(2):275-281. Published online May 30, 2024
- DOI: https://doi.org/10.4266/acc.2023.01606
- 9,403 View
- 205 Download
- 2 Web of Science
- 3 Crossref
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Abstract
PDF - Background
Patients with a fractured femur experience intense pain during positioning for neuraxial block for definitive surgery. Femoral nerve block (FNB) is therefore often given prior to positioning for analgesia. In our study, we compare the onset and quality of block of 0.25% bupivacaine, 0.5% ropivacaine, and 1.5% lignocaine for FNB in fracture femur patients.
Methods
Seventy-five adult femur fracture patients were equally and randomly divided into three groups to receive 15 ml of either 0.25% bupivacaine (group B), 0.5% ropivacaine (group R), or 1.5% lignocaine (group L) for FNB prior to positioning for neuraxial blockade. Onset and quality of block were assessed, as well as improvement in visual analog scale (VAS) score, ease of positioning, and patient satisfaction.
Results
Percentage decrease in VAS was found to be highest in group R (82.8%) followed by groups L and B. Time to achieve a VAS of less than 4 was found to be 26.2±2.4 minutes in group B, 8.5±1.9 minutes in group R, and 4.1±0.7 minutes in group L (P<0.001). In group B, 12 patients required additional fentanyl to achieve a VAS <4. Patient positioning was reported to be satisfactory in all patients in group R and L, while in B it was satisfactory in 13 (52%) patients only. Patient acceptance of FNB was 100% in group R and L, but only 64% in group B.
Conclusions
Based on our findings, 0.5% ropivacaine is a favorable choice for FNB due to early onset, ability to yield a good quality block, and good safety profile. -
Citations
Citations to this article as recorded by
- Efficacy and Safety of Ropivacaine versus Levobupivacaine in Ultrasound-Guided Femoral Nerve Blocks for Perioperative Analgesia in Femur Fracture Patients: A Systematic Review
Arpita Chowdhury, Vaskar Majumdar, Chirasree Chowdhury, Bhaskar Biswas, Simmons Debbarma
International Journal of Health Sciences and Research.2026; : 238. CrossRef - Concentration of local anesthetics is important in nerve blocks
Raghuraman M. Sethuraman
Acute and Critical Care.2025; 40(1): 150. CrossRef - Post-surgical pain: evolving drug treatments and challenges
Mohammad Khudirat, Loay Allafy, Bhuvrit Raj Dhakal, Adriana Baranov, Alparslan Turan
Expert Opinion on Pharmacotherapy.2025; 26(18): 2027. CrossRef
- Efficacy and Safety of Ropivacaine versus Levobupivacaine in Ultrasound-Guided Femoral Nerve Blocks for Perioperative Analgesia in Femur Fracture Patients: A Systematic Review
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