Intrathecal ropivacaine vs bupivacaine in endoscopic urological surgeries: a double blind randomized controlled trial

Abhishek Rao Kordcal,Madhu Rao,Vijaykumar Tipanna Kalyanappagol,Amrut Krishnananda Rao

doi:10.4038/slja.v27i2.8414

Abstract

Aims: To compare sensory, motor effects and haemodynamic stability of 2ml intrathecal isobaric ropivacaine (0.75%) with 3ml hyperbaric bupivacaine (0.75%) in patients undergoing endoscopic urological surgery. Study Design: Randomized controlled trial involving 142 patients undergoing transurethral resection of prostate (TURP) and URS (urethroscopy) in a tertiary care hospital, India. Methods and materials: Patients were randomly allocated to, Group 1 (3ml of 0.5% (15mg) hyperbaric bupivacaine) and Group 2 (2ml of 0.75% isobaric ropivacaine(15mg)). Onset and highest level of sensory block, onset and duration of motor block, quality of anaesthesia and muscle relaxation, haemodynamic parameters and adverse effects if any were studied. Statistical analysis used: Unpaired t-test was used to test continuous variables and chi square test/Fisher’s exact test for categorical variables. Results: The mean of highest sensory block, 2 segment regression of sensory block and time for sensory level to regress below T10 was significantly more in group 1 compared to group 2 (P Conclusion: Ropivacaine provides comparable quality of sensory block but has slower onset and significantly shorter duration of motor block compared to hyperbaric bupivacaine.

Highlights

Subarachnoid block (SAB) is a regionally acting local anaesthetic mainly used for performing transurethral resection of prostate and urethroscopy (URS).[1]
Ropivacaine provides comparable quality of sensory block but has slower onset and significantly shorter duration of motor block compared to hyperbaric bupivacaine
Subjects belonging to group-1 received 0.5% hyperbaric bupivacaine (15mg) and group[2] received 0.75% isobaric ropivacaine (15mg) through intrathecal route

Summary

Introduction

Subarachnoid block (SAB) is a regionally acting local anaesthetic mainly used for performing transurethral resection of prostate and urethroscopy (URS).[1] Bupivacaine has high potency and minimal neurological symptoms. In high concentration it is cardiotoxic.[2,3] Ropivacaine has lesser cardiotoxicity and has shorter motor block duration.[4] Many studies have compared the two drugs but with varying results especially with regard to duration of sensory and motor block and this could be clinically important. The primary aim of the study was to compare the onset and duration of sensory block and motor block, maximum height of sensory block, haemodynamic parameters and associated complications between isobaric ropivacaine and hyperbaric bupivacaine

Methods

Results

Conclusion