Lidocaine versus ropivacaine for continuous interscalene brachial plexus block after open shoulder surgery

A. Casati, F. Vinciguerra, M. Scarioni, G. Cappelleri, G. Aldegheri, P. Manzoni, G. Fraschini, J. E. Chelly

Research output: Contribution to journalArticlepeer-review


Background: This study compared the postoperative infusion of 1% lidocaine and 0.2% ropivacaine for continuous interscalene analgesia in patients undergoing open shoulder surgery. Methods: Forty patients undergoing open shoulder surgery received an interscalene brachial plexus block with 30 ml of either 1.5% lidocaine (n=20) or 0.5% ropivacaine (n=20), followed by a continuous patient-controlled interscalene analgesia with 1% lidocaine or 0.2% ropivacaine, respectively. A blinded observer recorded the quality of analgesia and recovery of motor function during the first 24 h of infusion. Results: Onset of the block occurred after 7.5 (5-40) min with lidocaine and 30 (10-60) min with ropivacaine (P=0.0005). Postoperative pain intensity was higher with lidocaine than ropivacaine for the first 8h of infusion. The ratio between boluses given and demanded from the pump was 0.5 (0.13-0.7) with lidocaine and 0.7 (0.4-1.0) with ropivacaine (P = 0.005). Rescue IV tramadol was required during the first 24 h of infusion by 16 patients of the lidocaine group (84%) and eight patients of the ropivacaine group (46%) (P = 0.05). At the 16 h and 24 h observation times a larger proportion of patients receiving ropivacaine had complete regression of motor block (70% and 95%) than patients receiving lidocaine (50% and 55%) (P = 0.05 and P = 0.013, respectively). Conclusions: Although 1% lidocaine can be effectively used for postoperative patient-controlled interscalene analgesia, 0.2% ropivacaine provides better pain relief and motor function.

Original languageEnglish
Pages (from-to)355-360
Number of pages6
JournalActa Anaesthesiologica Scandinavica
Issue number3
Publication statusPublished - Mar 2003


  • Continuous peripheral nerve blocks
  • Interscalene brachial plexus block
  • Lidocaine
  • Postoperative analgesia
  • Ropivacaine
  • Shoulder

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine


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