Abstract
Aims and Objective: Aim of the present study was to compare the clinical efficacy of 0.5% hyperbaric solutions of ropivacaine versus bupivacaine in terms of characteristics of spinal blockade, haemodynamic stability, recovery profile and side effects. Material and Method: The study enrolling 100 patients (age 20-60 years) of either sex, ASA grade I & II were randomly allocated in two groups. Group R received 3 ml of 0.5% hyperbaric ropivacaine with glucose 8.33% and Group B received 3 ml of 0.5% hyperbaric bupivacaine with glucose 8%. After induction, we studied the various parameters of subarachnoid block, hemodynamic variables, recovery and side effects. Result: Hyperbaric ropivacaine had late onset of sensory blockade, equal time to reach maximum dermatome level, early regression and shorter total duration of sensory blockade as compared to bupivacaine. Ropivacaine shows late onset of motor blockade, less degree and total duration of motor blockade as compared to bupivacaine. Ropivacaine was more hemodynamically stable as compared to bupivacaine. Both the sensory and motor blocks were subject to a more rapid recovery with ropivacaine compared with bupivacaine. Hyperbaric ropivacaine was not associated with any side effects intra and postoperatively. Conclusion: 3 ml of hyperbaric solution of ropivacaine 0.5% with glucose 8.33% can produce predictable and reliable spinal anaesthesia for a wide range of surgical procedure.
Highlights
The primary aims of anesthesia are to render adequate pain relief, thereby permitting the performance of surgical procedures without stress and discomfort
Since the introduction of spinal anesthesia in 1898 by Dr August Bier, who described the intrathecal administration of cocaine, spinal anesthesia is preferred over general anesthesia, in surgical procedures of lower abdomen and lower limbs [1]
Several recent studies have described the use of ropivacaine for spinal anaesthesia and it has been suggested that ropivacaine has shorter duration of action than bupivacaine
Summary
The primary aims of anesthesia are to render adequate pain relief, thereby permitting the performance of surgical procedures without stress and discomfort. Bupivacaine has been in clinical use as local anesthetic for more than 30 years and is available commercially as a racemic mixture containing equal proportions of the S (-) and R (-) isomers. It is being extensively used and produces an adequate sensory and motor blockade [3]. There have been reports of death attributable to bupivacaine induced cardio-toxicity in adults after accidental intravenous injection[4]. These adverse effects have prompted a search for new drugs with lesser toxicity
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