A clinical comparative study of 0.2% levobupivacaine with 25 mcg fentanyl versus 0.2% ropivacaine with 25 mcg fentanyl for post-operative epidural analgesia in patients undergoing lower limb orthopaedic surgeries

Abstract

Objectives: The objectives of our study were to compare the efficacy and safety of 0.2% Levobupivacaine with 25 mcg Fentanyl and 0.2% Ropivacaine with 25 mcg Fentanyl given epidurally for post-operative analgesia in patients who were operated electively for lower limb orthopaedic conditions under spinal anaesthesia. Materials and Methods: Sixty patients belonging to American Society of Anaesthesiologists (ASA) Class I and II of both sexes, of age within 20 - 60 years were included in the study after obtaining institutional ethical committee clearance. Patients were divided randomly into 2 groups: Group - LF which received 8 ml of 0.2% Levobupivacaine with 25 mcg Fentanyl and Group - RF which received 8 ml of 0.2% Ropivacaine with 25 mcg Fentanyl. Surgery was conducted under spinal anaesthesia. Later 8 ml of the test drug combination was given epidurally in the post-operative period when the patient complained of pain (VAS score > 4) and the parameters were recorded periodically until pain reappeared (VAS score > 4). Results: In both the groups mean duration of surgery, changes in haemodynamics and demographic profiles were comparable. However the total duration of post-operative analgesia in Levobupivacaine group was 325 +/- 63.06 minutes and in Ropivacaine group was 210 +/- 24.91 minutes respectively and this appeared to be statistically significant. Conclusion: Compared to 0.2% Ropivacine with 25 mcg Fentanyl, 0.2% Levobupivacaine with 25 mcg Fentanyl provides intense and longer duration of post-operative analgesia with similar haemodynamic stability. Keywords: Levobupivacaine, Ropivacaine, Fentanyl, Post-operative analgesia, Local anaesthetics.