Original Articles
A comparative study of effect of intrathecal hyperbaric 0.75% ropivacaine versus hyperbaric 0.5% bupivacaine for lower limb surgeries | |
Dr. Vishwanath Meti, Dr. K Lohit, Dr. Rohith Jamadar, Dr. Balaraju T C, Dr. Nikhil V Rathod | |
Introduction: Intrathecal bupivacaine heavy is routinely used for spinal anaesthesia for various below umbilical surgeries. Newer stereoselective, single enantiomer amide local anaesthetic agents, ropivacaine and levobupivacaine, which have lower cardiac toxicity are studied for intrathecal use. Ropivacaine is well tolerated after intrathecal use. To begin with it was available in isobaric preparation and earlier studies had to prepare the hyperbaric solution. But now hyperbaric preparations are readily available. We aimed to study and compare efficacy, characteristic and hemodynamic effects of hyperbaric 0.75%ropivacaine versus hyperbaric 0.5%bupivacaine for lower limb surgeries. Methodology: Prospective randomised control study, included 80 patients (40 in each group) aged 18 to 60 years of either sex belonging to ASA-Grade I&II scheduled for elective lower limb surgeries under spinal anaesthesia. Patients were randomly allocated into two groups. GroupR-3ml of hyperbaric 0.75% ropivacaine& GroupB-3ml of hyperbaric 0.5% bupivacaine. Variables like time taken for onset of sensory and motor blockade, duration of action and hemodynamic parameters of both drugs were compared. Results: Mean age and gender of two groups were statistically insignificant (p value 0.618). Hyperbaric ropivacaine exhibited significantly slower onset of sensory and shorter duration of sensory and motor blockade compared to hyperbaric bupivacaine (p value <0.001). Group-R demonstrated better hemodynamic stability compared to Group-B (p value<0.05). Conclusion: Hyperbaric ropivacaine provides late onset and short duration of sensory & motor blockade with better hemodynamic stability in comparison to hyperbaric bupivacaine. Ropivacaine facilitates early ambulation, enhances patient satisfaction, and is more efficient and can be used as alternative to bupivacaine. |
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