Abstract

 
 
 
 Introduction: Subarachnoid block is commonly employed technique for lower abdominal and lower limb procedures. Bupivacaine and ropivacaine are commonly used local anesthetics for subarachnoid block. The aim of this study is to compare the efficacy and safety of isobaric Ropivacaine over hyperbaric Bupivacaine.
 Methods: This was a prospective comparative study for a duration of six months. 60 ASA grade I-II adult patients between 16-60 years undergoing lower limb surgery under spinal anesthesia were randomized into two groups. Group I including patients who received 15 mg of hyperbaric bupivacaine 0.5% and group II including patients who received 22.5 mg of isobaric ropivacaine 0.75%. The onset and duration of sensory and motor block and hemodynamics including heart rate (HR), non invasive mean arterial blood pressure (MAP) and respiratory depression were recorded. Data were entered in Microsoft excel and statistical analysis was done by chi square test and T test using SPSS (version 23.0).
 Results: Both the groups were demographically statistically insignificant. Successful block was attained in all patients in both groups. The sensory onset and motor onset were significantly delayed in the Ropivacaine Group compared to the Bupivacaine Group P<0.001. There was no significant difference in the hemodynamics (heart rate and mean arterial pressure ).
 Conclusions: Though isobaric ropivacaine provided lesser degree of sensory and motor block with delayed onset compared to hyperbaric bupivacaine, it can effectively and safely used in subarachnoid block in lower limb surgeries without any major hemodynamic changes and adverse effects.
 
 
 
Highlights
Subarachnoid block is commonly employed technique for lower abdominal and lower limb procedures
Though isobaric ropivacaine provided lesser degree of sensory and motor block with delayed onset compared to hyperbaric bupivacaine, it can effectively and safely used in subarachnoid block in lower limb surgeries without any major hemodynamic changes and adverse effects
Hemodynamic changes : The changes in heart rate and mean arterial pressure of the groups after injection of anesthetic solution are shown in figure 1 and 2 below
Summary
Subarachnoid block is commonly employed technique for lower abdominal and lower limb procedures. Bupivacaine is largely used for spinal anesthesia, mainly as hyperbaric solution.[1] Ropivacaine is one of the amide local anesthetic group with a chemical structure close to bupivacaine but with a better safety profile because it has the advantage of being less cardiotoxic with lower propensity for motor block and can be used as an alternative to bupivacaine.[2]. The objective of the study was to compare isobaric ropivacaine with hyperbaric bupivacaine used for spinal anesthesia in lower limb surgery in terms of efficacy, safety, hemodynamic changes and adverse effect. This was a randomized prospective comparative study. Group I(n=30) received an intrathecal injection of 3ml of 0.5% hyperbaric bupivacaine(15mg) while Group II (n=30) received an intrathecal injection of 3 ml of 0.75% isobaric ropivacaine (22.5mg)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
