A Comparative Study of Intrathecal Isobaric 0.5% Ropivacaine with Isobaric 0.5% Bupivacaine in Elective Lower Abdominal and Lower Limb Surgeries
Journal Title: Indian Journal of Anesthesia and Analgesia - Year 2018, Vol 5, Issue 10
Abstract
Ropivacaine has a lower and different toxicity profile compared to Bupivacaine. It is a new longacting, enantiomerically pure (Senantiomers), amide local anaesthetic with a high pKa and low lipid solubility. T. Ropivacaine has a greater degree of motor sensory differentiation, which could be useful when motor blockade is undesirable. The reduced lipophilicity is also associated with decreased potential for central nervous system toxicity and cardio toxicity. Ropivacaine should be a favorable local anesthetic for daycase surgery and could be associated with earlier postoperative mobilization than Bupivacaine. Objective of Study: To compare the effects of intrathecal hyperbaric 4 ml of 0.5% Ropivacaine with 4 ml of hyperbaric 0.5% Bupivacaine in a ratio of 1:1 by volume (Ropivacaine 16.5 mg and Bupivacaine 11 mg) for lower abdominal/lower limb orthopedic surgeries with regard to: Onset and duration of sensory block, motor block. Maximum height of sensory block. Quality of anesthesia and Adverse reactions if any after taking written informed consent. Observations: Onset of motor blockade was slower and duration of motor blockade was shorter with Ropivacaine compared to Bupivacaine. However, all the patients in either groups attained complete motor blockade. With respect to hemodynamic parameters intrathecal Ropivacaine provided a higher Degree of cardiovascular stability with a lesser incidence of hypotension and bradycardia was observed. Result: There is delayed onset of motor block and shorter duration of motor block with Ropivacaine compared to Bupivacaine. Cardiovascular stability is better than Bupivacaine. Hence, Ropivacaine can be used successfully for lower limb/abdominal surgeries where early recovery is well appreciated by the patients
Authors and Affiliations
Sandhya Gujar
Comparison of the Effects of using three Different Types of Needles on Sub Arachnoid Block: A Clinical Study
Background: Anaesthesia alleviates human sufferings during the surgical procedures. It may be either General anaesthesia or Regional anaesthesia depending upon surgery. General anaesthesia imparts total sensory loss. It...
Comparison of Intravenous Dexmedetomidine Alone and in Combination with Midazolam as Premedication in Patients Receiving Spinal Anaesthesia
Study Objective: To compare intravenous dexmedetomidine in combination with midazolam and dexmedetomidineas premedication in patients receiving spinal anaesthesia. Design: Prospective randomized controlled double blind s...
A Comparative Evaluation of Rocuronium and Suxamethonium Following Rapid Sequence Intubationin Emergency Surgeries
Introduction: Endotracheal intubation is an integral part of administration of anaesthesia during surgical procedures. Administration of muscle relaxants facilitates endotracheal intubation. Various drugs and techniques...
A Prospective Observational Study – Epidural Catheter Insertion Site and Adequacy of Post-Operative Pain Relief in Children undergoing Thoracic and Upper Abdominal Surgeries
Background and aims: Effective postoperative pain relief from epidural analgesia has numerous benefits including earlier ambulation, rapid weaning from ventilators, lowered circulating stress hormone levels. Precise plac...
A Case Report of Ca. Breast Patient with Metastasis, DVT and Hypoalbuminemia Posted for Modified Radical Mastectomy Under Thoracic Epidural Anaesthesia: A Challenge for Anaesthesiologist
Modified Radical Mastectomy, the surgical procedure for carcinoma of breast is routinely performed under general anaesthesia. Patient with lung metastasis and low serum albumin are at increased risk of perioperative morb...