COMPARATIVE EVALUATION OF HAEMODYNAMIC CHANGES AND COMPLICATIONS ASSOCIATED WITH TWO DIFFERENT DOSES OF ROPIVACAINE HYDROCHLORIDE (0.75% AND 0.5%) IN SPINAL ANAESTHESIA IN LOWER LIMB ORTHOPAEDIC SURGERIES
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 63
Abstract
BACKGROUND The introduction of safe drugs enhanced the popularity of spinal anaesthesia. Lofgren and Lundqvist introduced the most commonly used drug, Lignocaine. One of the disadvantages of Lignocaine was the association with transient neurological symptoms, which presents as low backache and lower extremity dysesthesia. Bupivacaine was introduced by Ekenstam in 1957. It is a well-established long-acting local anaesthetic used for spinal anaesthesia. It has been used frequently in spinal anaesthesia with a very little incidence of transient neurological symptoms. But it is associated with cardiovascular and central nervous system toxicity when used in high concentration or when accidentally administered intravascularly. Ropivacaine was introduced into clinical practice in 1996. It was initially used in epidural anaesthesia in lower extremity surgery, where it was compared with bupivacaine where they concluded that ropivacaine produced similar sensory and motor blockade with less cardiotoxicity. In a study, different concentrations of intrathecal ropivacaine 0.5% and 0.75% were compared for vascular surgery, which concluded that 15 mg of plain ropivacaine 0.75% is effective and safe and gives complete spinal anaesthesia in high risk patients without side effects and cardiovascular modifications. The aim of this study was to compare and evaluate the haemodynamic changes and side effects associated with equal volumes of two different doses of ropivacaine hydrochloride (0.75% and 0.5%) used in spinal anaesthesia in lower limb orthopaedic surgeries. MATERIALS AND METHODS It is a prospective, randomised, double blind study conducted in a tertiary care hospital in which 80 patients of age group 20 - 65 years of either sex which were scheduled to undergo lower limb orthopaedic surgeries under spinal anaesthesia with two different doses of Ropivacaine Hydrochloride were included. The patients were randomly divided into 2 groups of 40 each. Group A received 22.5 mg (3 mL) of 0.75% isobaric Ropivacaine Hydrochloride. Group B patients received 15 mg (3 mL) of 0.5% isobaric Ropivacaine Hydrochloride. RESULTS The haemodynamic profile of both the groups was comparable, both intra- as well as post-operatively. In terms of safety, both doses of intrathecal ropivacaine provided high degree of cardiovascular stability with a low incidence of bradycardia and hypotension. On comparing side effects and complications, both the doses of intrathecal ropivacaine had low incidence of adverse effects. CONCLUSION Both ropivacaine 0.75% and 0.5% produced minimal side effects and complications as well as provided high degree of cardiovascular stability, hence recommended for anaesthetic use in prolonged lower limb orthopaedic surgeries.
Authors and Affiliations
Shafaqat Rashid, Suhail Vakil, Zameer Ali, Roshani Deshmukh, Mehreen Rashid, Swarn Gulati, Basharat Ahad
Keywords
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- EP ID EP231453
- DOI 10.14260/Jemds/2017/998
- Views 64
- Downloads 0
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