Lateral approach to the sciatic nerve in the popliteal fossa:: A comparison between 1.5% mepivacaine and 0.75% ropivacaine

Background and objectives: Ropivacaine and mepivacaine are commonly used local anesthetics for peripheral nerve blockade. The purpose of the present study was to compare onset time, quality of anesthesia, and duration of analgesia with ropivacame 0.75% and mepivacame 1.5% for lateral popliteal nerve block. Methods: Fifty American Society of Anesthesiologists (ASA) physical status I or II patients scheduled for foot and ankle surgery with calf tourniquet under lateral popliteal sciatic nerve block were randomly assigned to receive 30 mL of either ropivacame 0.75% or mepivacame 1.5%. Time required for onset of sensory and motor block, resolution of motor blockade, onset of postsurgical pain, and time of first analgesic medication were recorded. Results: The 2 groups were similar with regard to demographic variables and duration of surgery. Onset of sensory and motor block was significantly shorter in the mepivacame group (9.9 +/- 3.3 min and 14.7 +/- 3.6 min, respectively) than in the ropivacame group (18.1 +/- 6.1 min and 23.6 +/- 5.5 min, respectively) (P < 0.001). Resolution of motor block occurred later in the ropivacame group than in the mepivacame group (P < 0.001), and duration of postoperative analgesia was significantly longer in the ropivacame group (19 +/- 3.4 h) compared with the mepivacame group (5.9 +/- 1.1 h) (P < 0.001). Analgesic requirements were higher in mepivacaine group than in the ropivacame group (P < 0.001). There were 2 failed blocks, one in each group. Conclusions: Both ropivacaine and mepivacaine provided effective sciatic nerve blockade. Mepivacaine 1.5% displayed a significantly shorter onset time than ropivacaine 0.75%. Postoperatively, ropivacame 0.75% resulted in longer-lasting analgesia and less need for oral pain medication.