Title: Comparison of Intrathecal 0.5% hyperbaric bupivacaine with 0.5%   hyperbaric ropivacaine in lower limb and lower abdominal surgery

Authors: Swetha Purohit, Ramachandra Badami, Chandrashekarappa Kavi

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i8.166

Abstract


Background: Spinal Anesthesia is most preferred technique for Lower Limb and Lower Abdominal surgeries. This study was designed to compare the clinical efficacy of hyperbaric solutions of  0.5% Ropivacaine and Bupivacaine.

Methods: After obtaining ethical committee clearance and informed patient consent 100 ASA grade I and II patients undergoing elective lower-abdominal and lower-limb surgeries under spinal anaesthesia were recruited and randomized to receive 3mlRopivacaine(with glucose 83 mg/ ml) or 3 ml Bupivacaine  (with glucose 80 mg /ml).Groups were named as group R and B respectively.

The parameters that were compared were onset(primary outcome) and duration of sensory block, intensity and duration of motor block(secondary outcomes) and recovery profile. P<0.05 was considered to be statistically significant.

Result: Ropivacaine as compared to Bupivacaine showed slower onset of sensory block, shorter time to regression and shorter duration of sensory block. Motor block also was delayed with respect to onset,degree of block and duration for Ropivacaine group compared to Bupivacaine group. Patients receiving ropivacaine recovered faster in terms of  mobilization(Group R vs B- mean 253.5 min vs 331 min) and time to micturate (Group R vs B -mean 276 min and 340.5 min). Hemodynamics were stable  in Group R as compared to B as More patients in thebupivacaine group required treatment for hypotension .Intraoperative and post operative periods were free of Side effects in the Group R.

Conclusion: Hyperbaric Ropivacaine 0.5% with 83 mg/ml of glucose provides reliable spinal anaesthesia ofshorter duration and with less hypotension than bupivacaine and can provide a safe alternative to Bupivacaine in day care setting for infraumbilical surgeries.

Key Words: Hyperbaric, Bupivacaine,Ropivacaine,spinal.

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