Intrathecal ropivacaine with fentanyl for LSCS Comparison of hyperbaric and isobaric solution

Abstract

We compared the characteristics of spinal anesthesia with plain and hyperbaric ropivacaine for LSCS. Method:-In this prospective randomized double blind study 60 pregnant patient of ASA physical status1&2 were given 15mg of either isobaric ropivacaine(n=30) or hyperbaric ropivacaine(n=30) in glucose 8% along with fentanyl 25mcg intrathecally for LSCS. The characteristics of spinal anesthesia, hemodynamic parameters, quality of anesthesia and muscle relaxation as well as duration of post-operative analgesia were compared. RESULT: -There were no significant difference in median time to onset of sensory block at T6 (plain6.33±4.62 vs. hyperbaric 4.52±2.84 minutes; p>0.05), maximum sensory level achieved (plain 8.10±3.92 vs. Hyperbaric 6.63±2.47 min, p>0.05) and onset of grade 3 motor block (plain 8.20±5.38 vs. hyperbaric 6.10±2.38 minutes; p>0.05). Median maximum extent achieved was also comparable, but in group H duration of sensory (plain 206.23±24.42 vs. hyperbaric164.50±30.29 min., p<0.001) and motor blockade (plain170.50±39.19vs hyperbaric 133.33±30.17min; p<0.001) and duration of post-operative analgesia were significantly shorter. Incidences of hypotension were more in the group H (43.33%) compared with group I (23.33%). Quality of anesthesia and muscle relaxation was satisfactory in most patients in either group. Total duration of analgesia was 218.37±28.74min in group H and 239.30±28.28min. In group I(p<0.05). CONCLUSION: 15mg of (0.75%) hyperbaric ropivacaine provides similar, reliable and effective quality of spinal anesthesia with shorter duration of sensory and motor block, when compared with 15mg of (0.75%) isobaric ropivacaine.