Comparison of 0.5% levobupivacaine and 0.75% ropivacaine in spinal anaesthesia for urological surgeries - Randomised double blinded study
Journal Title: Medpulse International Journal of Anesthesiology - Year 2019, Vol 9, Issue 2
Abstract
Background: bupivacaine is commonly used drug for spinal anaesthesia in urological surgeries. Levobupivacaine and Ropivacaine are comparatively newer drug with lesser side effects. Though both these drugs were widely used, their effectiveness in achieving motor blockade remains a debate. Objective: To evaluate the efficacy of Isobaric 0.5% Levobupivacaine and Isobaric 0.75% Ropivacaine in producing motor blockade in spinal anaesthesia in urological surgeries. Methods: This study was conducted in the department of Anaesthesiology in Meenakshi Medical College Hospital and Research Institute, Kanchipuram during the period of February 2017 to August 2018. A total of sixty participants undergoing urological surgical procedures with 30 participants in group A (0.5% Levobupivacaine 3ml) and another 30 participants in group B (0.75% Ropivacaine 3ml) were included in the study. Patients with in the age of 1860 years, weighing between 50100 kgs, belongs to ASA physical status I and II were included in the study. Patients who were known hypersensitivity to either Levobupivacaine and Ropivacaine, contraindicated for spinal anaesthesia, poor LV function, IHD, any degree of AV block and arrhythmias were excluded from the study. Results: Mean time for onset of sensory function was 5.9±1.3 minutes and 6.3±1.2 minutes in group A and B respectively. Mean time for onset of motor function after spinal anaesthesia was found to be 13.4±1.2 minutes in group A and 12.5±1.5 minutes in group B and also it was found to be statisti cally significant (p=0.031). Time for maximum sensory loss was 13.6±1.1 minutes and 12.4±1.1 minutes in group A and group B respectively and it was found to be statistically significant (0.001). Though there were minimal changes noted in pulse rate, systolic and diastolic blood pressure in both the groups, the changes were found to be statistically insignificant. Total duration of motor blockade in group A and group B was found to be 95.6±24.5 minutes and 115.3±13.3, minutes respectively. This was found to be statistically significant between the groups. Total duration of sensory blockade was found to be 89.7±16.2 minutes and 94.4±15.1 minutes in group A and group B respectively. It was found to be statistically insignificant. Conclusion: We concluded that Ropivacaine is comparatively better than Levobupivacaine in terms of providing motor blockade without altering the haemodynamic parameters like pulse rate, systolic and diastolic blood pressure and oxygen saturation.
Authors and Affiliations
Vinod Selvin, U G Thirumaaran, Selvakumaran .
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