EFFICACY OF 0.5% HYPERBARIC BUPIVACAINE VERSUS 0.75% ISOBARIC ROPIVACAINE FOR LOWER LIMB SURGERIES – A COMPARATIVE STUDY

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Dr Ravi Teja Vallabha
Dr. Upputuri Vijaya Sekhar
Dr T Phaneendra Reddy
Dr Kiran Karnati

Keywords

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Abstract

BACKGROUND: Ropivacaine, a recently introduced local anaesthetic, has approximately 40% reduced potency compared to bupivacaine. The objective of this study was to compare the clinical effectiveness of hyperbaric 0.75% ropivacaine and 0.5% bupivacaine for spinal anaesthesia during lower limb surgeries.


 METHODOLOGY: A randomized double-blinded study was carried out in 60 participants who were divided into 2 groups. Group B were given 2ml intrathecal injection of 0.5% hyperbaric Bupivacaine kg while Group R were given an intrathecal dose of 2ml of 0.75% isobaric Ropivacaine. The variables like time taken for onset of sensory and motor block, duration of the blocks, time taken to reach T10 level were recorded.


 RESULTS: Ropivacaine's slower time to motor blockade onset and shorter motor blockade duration compared to Bupivacaine were both highly significant with P value of 0.0001.


 CONCLUSION: The utilisation of ropivacaine's recovery profile may prove advantageous in situations when immediate mobilisation is necessary.

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References

1. Wulf H.F.W. The centennial of spinal Anesthesia Anesthesiology. 1998:89 500-506.
2. Pollock JE, Neal JM, Stephenson CA, Wiley CE. Prospective study of the incidence of transient radicular irritation in patients undergoing spinal anesthesia. Anesthesiology 1996;84:1361-7.
3. Cpogna G, Cellono D, Fusco P, Lyons G, Columb M, relative potencies of bupivacaine and ropivacaine for analgesia in labor Br J Anaesth 1999; 82: 371.
4. Yamashita A, Matsumoto M, Matsumoto S, Itoh M, Kawai K, Sakabe T. A comparison of the neurotoxic effects on the spinal cord of tetracaine, lidocaine, bupivacaine, and ropivacaine administered intrathecally in rabbits. Anesth Analg 2003;97:512- 9.
5. Helena Kallio, Eljas-Veil T.Snall, Sami J.Suvanto, Carl A. Tuomas, Mauri K. Iivonen et al, Spinal hyperbaric ropivacaine fentanyl for day surgery, Regional anaesthesia and pain medicine, Jan/Feb 2005, volume 30, 48-54.
6. Jean-Marc Malinovsky, Florence Charles,Ottmar Kick, MD, Jean-Yves Lepage, Myriam Malinge, Antoine Cozian, MD, Olivier Bouchot, Michel Pinaud, Intrathecal Anesthesia: Ropivacaine Versus Bupivacaine Anesthesia and analgesia, December 2000 vol. 91 no. 6 1457-1460.
7. Luck JF, Fettes PD, Wildsmith JA. Spinal anaesthesia for elective surgery: A comparison of hyperbaric solutions of racemic bupivacaine, levobupivacaine, and ropivacaine. Br J Anaesth 2008;101:705-10.
8. Gautier C, de Kock M, Van Steenberge A, Poth N, Lahaye- Goffart B, Farnard L, Hody JL. Intrathecal ropivacaine for ambulatory surgery. A comparison between intrathecal ropivacaine for knee arthroscopy. Anesthesiology 1999;91:1239-1245.
9. Mantouvalou M, Ralli S, Arnaoutoglou H, Tziris G, Papadopoulos G. Spinal anesthesia: comparison of plain ropivacaine, bupivacaine and levobupivacaine for lower abdominal surgery. Acta Anaesthesiol Belg. 2008;59(2):65–71.
10. Kallio H, Snäll EVT, Tuomas CA, Rosenberg PH. Comparison of hyperbaric and plain ropivacaine 15 mg in spinal anaesthesia for lower limb surgery. British Journal of Anaesthesia. 2004 Nov;93(5):664–9.
11. McDonald SB, Liu SS, Kopacz DJ, Stephenson CA. Hyperbaric spinal ropivacaine: a comparison to bupivacaine in volunteers. Anesthesiology 1999; 90: 971-7.