Effects of 0.25% Ropivacaine versus 0.25% Bupivacaine in Erector Spinae Plane Block on Interleukin-6 Levels in Post-Thoracotomy Patients

Abstract

Background: Thoracotomy induces a pronounced systemic inflammatory response, with interleukin-6 (IL-6) serving as a key mediator of the acute-phase reaction. Regional anesthesia techniques such as the erector spinae plane (ESP) block may modulate perioperative inflammation; however, whether different local anesthetics influence postoperative IL-6 levels remains unclear. This study compared the effects of 0.25% bupivacaine and 0.25% ropivacaine administered via ESP block on serum IL-6 levels in patients undergoing thoracotomy.

Methods: A double-blind randomized controlled trial was conducted at a tertiary referral hospital in Makassar, Indonesia. Thirty patients undergoing thoracotomy were randomly assigned to receive ultrasound-guided ESP block with either 15 mL of 0.25% bupivacaine (Group B) or 15 mL of 0.25% ropivacaine (Group R). Venous blood samples were collected at baseline (0 h), 12 h, and 24 h postoperatively for IL-6 measurement using ELISA. Data were analyzed using appropriate parametric or non-parametric tests, with p < 0.05 considered statistically significant.

Results: Baseline characteristics were comparable between groups. Mean IL-6 levels at 0 h were 6.13 ± 6.20 pg/mL in Group B and 6.27 ± 9.83 pg/mL in Group R (p = 0.815). At 12 h, levels were 5.27 ± 5.96 pg/mL and 2.25 ± 1.11 pg/mL, respectively (p = 0.860). At 24 h, IL-6 levels were 6.85 ± 8.08 pg/mL in Group B and 5.18 ± 10.02 pg/mL in Group R (p = 0.880). No statistically significant differences were observed at any time point.

Conclusion: Bupivacaine and ropivacaine administered via ESP block produce comparable postoperative IL-6 profiles following thoracotomy.