Abstract
Epidural blockade unlike spinal anaesthesia, gives the clinician an opportunity to provide adequate anaesthesia for extended duration of surgical needs and enable excellent pain management well into the postoperative period. It provides better haemodynamic stability due to minimal sympathetic blockade. The present study used ropivacaine and levobupivacaine, which have recently been introduced for clinical use to compare the onset and duration of motor and sensory blockade in patients undergoing lower abdominal surgeries under epidural anaesthesia. The mean onset of sensory block in group R and group L were 17.93 ± 2.98 and 18.62 ± 3.09 minutes respectively; p= 0.285. The mean onset time of motor block was slightly longer in group L compared to group R (24.09 ± 3.07 vs 25.47 ± 4.13 minutes; p = 0.076). Mean duration of sensory block was slightly longer in group R compared to group L (196.78 ± 20.31 vs 189.0 ± 19.53 minutes; p = 0.067).The duration of post op analgesia was observed to be longer in group R (263.0 ± 22.77) in comparison to group L (253.78 ± 24.43). The duration of motor block was found to be lesser in group R(111.42 ± 16.70 min) compared to that in group L(118.53 ± 18.14 min), the difference being statistically insignificant (p=0.05). It can thus be concluded that both 0.75% ropivacaine and 0.5% levobupivacaine when administered epidurally for elective lower abdominal surgeries, provide adequate and comparable sensory and motor blockade.
Highlights
The history of neuraxial anaesthesia goes back as far as the 19th century
Epidural anaesthesia is more versatile than spinal anaesthesia, and has recently developed into the anaesthetic technique of choice for most of the abdominal and lower limb surgeries owing to its advantage of outstanding pain relief in the postoperative period.[1]
Materials and Methods Patients aged between 20 to 60 years of either gender, belonging to ASA Grade I and II scheduled for elective lower abdominal surgeries under epidural anaesthesia were studied
Summary
The history of neuraxial anaesthesia goes back as far as the 19th century. Experiments by scientists like Corning, Bier, Pages and progressive research has led to its application in a variety of clinical situations.[1,2] Epidural anaesthesia is more versatile than spinal anaesthesia, and has recently developed into the anaesthetic technique of choice for most of the abdominal and lower limb surgeries owing to its advantage of outstanding pain relief in the postoperative period.[1] It produces segmental blockade unlike spinal anaesthesia, providing better haemodynamic stability due to minimal sympathetic blockade.[3]. Bupivacaine, a racemic mixture of dextrobupivacaine and levobupivacaine, provides a long duration of action and a favourable ratio of sensory to motor neural block.[4] But its use is limited by its cardiac and central nervous system toxicity[5,6,7,8] prompting research for newer drugs devoid of such side effects. Ropivacaine and levobupivacaine, claim benefits of more selective action on sensory fibres and reduced cardiac adverse effects.[9]
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