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Introduction : The interscalene approach to the brachial plexus for shoulder surgeries provides excellent anaesthesia with remarkable safety and minimal or no systemic disturabances. Material and Methods : 60 abult patients ASA I-II undergoing elective shoulder surgery. Patients were randomly allocated into 3 groups. The patients recived 20ml of either ropivacaine 1% GI (20 patients), ropivacaine 0.75% GII (20 patients) and bupivacaine 0.5% GIII (20 patients). Onset time of sensory and motor block, duration of analgesia and the need for supplementary analgesics were recorded. Pain was assessed by using VAPS. Haemodynamic parameters, oxygen saturation and respiratory rate were recorded. Unwanted side effects, cardiovascular, neurological, nausea and vomiting etc were recorded. Also, patients satisfaction were noted. The pharmacological study was done on pentobarbitone cats to determine the effect of different doses of ropivacaine (0.35-2.8mg/kg) versus buipvacaine (0.5-4mg/kg) on arterial blood pressure, ECG and respiratory rate. Results: The mean onset time of analgesia was faster in ropivacaine groups than bupivacaine group (p‹0.005). The studied groups were comparable regarding the duration of analgesia, motor and sensory block, cadio vascular and respiratory effects. The incidence of paraesthesia was more frequent in bupivacaine group than both ropivacaine groups (30% vs 10%) There was more patient satisfaction in ropivacaine groups than bupivacaine groups. On the other hand the pharmacological study showed that ropivacaine had more less toxic effects on cardiovascular and respiratory systems. Conclusion : This study concluded that interscalene block performed with either 0.75% or 1% ropivacaine allows for a prolonged postoperative pain relief similar to bupivacaine 0.5% with shorter onset time, more cardiovascular Introduction : Interscalene brachial plexus block (ISB) is used to provide anaesthesia and analgesia for shoulder surgery. Single injection interscalene brachial plexus block is an effective anaesthetic; however it is limited by the duration of action of local anaesthetic. Bupivacaine and ropivacaine have been compared both at different an equal volumes and concentration for ISB. Kinnard and Lirette, (1996). Bupivacaine is a long-acting local anaesthetic which has been reported to be associated with slower onset time for nerve blockade compared with other intermediate stability and higher patient satisfaction.

Introduction:- Regional analgesia provides excellent pain relif in labour. This study was designed to compare combined spinal eqidural (CSE) versus epidural block using a narcotic (sufentanil) and local anaesthetic bupivacaine regarding their effects on progress of labour, method of delivery, pain relif, side effects and neonatal outcome. Patients and Methods :-Forty pregnant women ASA I and II were enrolled in this study. The women were randomly allocated to receive either CSE or epidural ( 20 patient of each ). In CSE group analgesia was initiated with 10ug sufentanil with 2mg bupivacaine. In epidural group 10ml bupivacaine 0.125%.and 10ug sufentanil injected epidurally. In both groups the continuous infusion of 0.83% bupivacaine with 0.33ug/ml sufentanil at 10ml/hr adjusted as required. Maternal haemodynamics, analgesia characteristics VAPS, degree of motor block, were measured. Duration of labour, cervical dilation, maternal satisfaction and mode of delivery were assessed. Foetal outcome was assessed by 1 and 5 min. Apgar score and umbilical venous blood gases. Maternal and neonatal side effects were observed. The experimental study was done on 30 rats divided into 3 groups 10 rats of each. Control group (A) injected intrathecally with saline, group (B) injected intrathecally with 1.5ug/kg sufentanil (low dose), and group (C) injected intrathecally with 7.5ug/kg sufentanil (high dose), the pervious doses were injected every 2hr. for 3 times then the spinal cord was obtained and stained for histological evaluation. Results:- The clinical study showed that no difference between the 2 groups for the degree of motor block or adequacy of analgesia, mode of delivery and Foetal outcome. The onset of analgesia was faster with CSE technique, more patient satisfaction and more pruritis. The histological results revealed that no detectable significant neurotoxic changes with the use of small dose of intrathecal sufentanil but mild changes occurred with high dose. Conclusion :- So the study concluded that both CSE and epidural analgesia with sufentanial and bupivaine can provide effective labour analgesia with minimal or no side effects.