Abstract :
Background: Lumbar disc prolapse is a common cause of lower back pain and radiculopathy. Selective nerve root block (SNRB) is frequently employed to alleviate radicular symptoms, but the comparative performance of commonly used local anaesthetics remains debated.Objective: To compare the analgesic efficacy and safety of ropivacaine and bupivacaine when used for SNRB in patients with unilateral lower lumbar disc prolapse.Materials and Methods: Sixty adults with magnetic resonance imaging?confirmed disc prolapse at L4–L5 or L5–S1 and persistent radiculopathy despite conservative care were randomised to receive 3 mL of either 0.5 % ropivacaine (Group R) or 0.5 % bupivacaine (Group B) during fluoroscopy?guided SNRB. Pain intensity (visual analogue scale [VAS]), functional status (Oswestry Disability Index [ODI]), onset and duration of analgesia, motor block (modified Bromage scale) and adverse events were recorded at baseline and at predefined intervals for one week.Results: Both groups experienced significant reductions in VAS scores and comparable improvements in ODI. The onset of analgesia and duration of pain relief were similar in both groups (p > 0.05). However, ropivacaine was associated with a lower incidence of motor block and fewer adverse events.Conclusion: Ropivacaine and bupivacaine provided equivalent short?term pain relief and functional improvement during SNRB for lower lumbar disc prolapse. Ropivacaine’s more favourable safety profile and reduced motor blockade suggest it is preferable for outpatient procedures and early ambulation. Larger studies with longer follow?up and inclusion of adjuncts such as corticosteroids are warranted.
Keyword :
Ropivacaine, Bupivacaine; Selective nerve root block, Lumbar vertebrae, Intervertebral disc displacement, Radiculopathy, Pain measurement, Treatment outcome, Randomized controlled trial, Local anaesthetics