A randomized, prospective, comparative study to evaluate the haemodynamic changes of 3ml of 0.5% isobaric levobupivacaine and 3ml of 0.5% isobaric ropivacaine for spinal anaesthesia in patients undergoing elective lower limb orthopaedic surgeries
Journal Title: Medpulse International Journal of Anesthesiology - Year 2018, Vol 7, Issue 3
Abstract
Background: Levobupivacaine and Ropivacaine have been recently introduced in India, Although levobupivacaine is theoretically more potent than ropivacaine, clinical studies show conflicting results in terms of anesthetic and analgesic characteristics. Many studies have showed that equipotent doses of ropivacaine and levobupivacaine have similar efficacy in peripheral nerve plexus block and epidural anesthesia in ambulatory patients, as well as when administered by topical application or local infiltration. Not many studies have been done in India comparing the use of isobaric Levobupivacaine 0.5% and isobaric Ropivacaine 0.5% for spinal anaesthesia. Hence the present study was undertaken to evaluate the haemodynamic changes of 3ml of 0.5% isobaric levobupivacaine and 3ml of 0.5% isobaric ropivacaine for spinal anaesthesia in patients ndergoing elective lower limb orthopaedic surgeries. Materials and Methods: Group A (n=30) received Levobupivacaine 0.5% and group B (n=30) Ropivacaine0.5%. Heart Rate, SBP, DBP, MAP were recorded at various time intervals Results: There is no statistically significant difference in the mean heart rate and the mean diastolic blood pressure between the two groups at various time intervals. There is no statistically significant difference between the two groups for mean systolic blood pressure except at 80th and 90th minutes. Clinically there was no significant hypotension necessitating the administration of injection mephenteremine. There is no statistically significant difference in mean arterial pressure between the two groups except at 70th, 80th and 90th minutes. Conclusion: There was no statistically significant difference in heart rate, DBP monitored at various intervals between the 0.5% isobaric Levobupivacaine (15 mg) group and 0.5% isobaric Ropivacaine (15 mg) groups in patients undergoing elective lower limb orthopaedic surgeries. Though inter group difference in SBP at 80th and 90th min and in MAP at 70th, 80th and 90th min was statistically significant, it was clinically insignificant as there was no need to use vasopressor.
Authors and Affiliations
Suresh S B, Prasanna Kumara V R
Comparison of Analgesic Efficacy of Butorphanol and Fentanyl in Various Surgeries
Background: An ideal perioperative analgesic should offer protection against the pressor response should provide intense analgesia sufficient to relieve pain of surgical incision, maintain the haemodynamic parameters and...
Clonidine- An ideal premedicant for attenuation of haemodynamic side effects of intravenous Ketamine anaesthesia
Background: Using Ketamine as an anaesthetic agent is often associated with tachycardia and hypertension due to cardiostimulatory effects. Clonidine being an α2 agonist is supposed to be an ideal premedicant for it. Mate...
A comparative study of efficacy of different doses of fentanyl in the prevention of incision related tachycardia in children
Background: Pain is a subjective sensation and assessment of pain during general anaesthesia is a difficult preposition. It can only be assessed indirectly by noting the features of a stress response like tachycardia and...
A comparative study of ropivacaine 0.5% and bupivacaine 0.5% in combination with fentanyl in supraclavicular brachial plexus block
Background: Regional anaesthesia now occupies an important position in anaesthesia now days and has undergone advancements both in techniques and drug availability. Regional anaesthesia techniques are an important assort...
Comparison of intrathecal dexmedetomidine - 0.5% heavy bupivacaine combination with intrathecal 0.5% heavy bupivacaine alone for lower limb and lower abdominal surgeries
Aims: To assess the effects of intrathecal dexmedetomidine on the onset and duration of action of sensory and motor block, haemodynamic alteration, associated complications, level of sedation and intraoperative analgesia...