Comparison of onset and duration of blockade between equipotent doses of ropivacaine-fentanyl and bupivacaine-fentanyl in lower abdominal surgeries under spinal anesthesia - A controlled study
Journal Title: MedPulse -International Medical Journal - Year 2019, Vol 6, Issue 1
Abstract
Background: Effective analgesia with early ambulation is becoming more important, especially for day care patients. This study aims to compare, onset and duration of blockade between equipotent doses of ropivacaine-fentanyl and bupivacaine-fentanyl in lower abdominal surgeries under spinal anesthesia. Aim and Objective: To compare the efficacy of isobaric 0.75 % ropivacaine with isobaric 0.5 % bupivacaine after addition of fentanyl to both group, in spinal anaesthesia for lower abdominal surgeries. Material and Method: This hospital based controlled study was done on 100 patients, undergoing elective lower abdominal surgeries under spinal anaesthesia. Patients were distributed into two groups of 50 each i.e Group B (2.5 cc of 0.5% Bupivacaine plus 0.5 cc of Fentanyl) and Group R (2.5 cc of 0.75% Ropivacaine plus 0.5 cc Fentanyl. Following things are required. Weighing machine, I.V. cannula 18G/20G, I.V. infusion sets I.V. fluids crystalloids and colloids, Anaesthesia machine, Cuffed endotracheal tubes of appropriate sizes, Appropriate size masks and bags , Macintosh laryngoscope No. 2, 3 and 4 , Suction apparatus and catheters, Bain’s circuit /Closed circuit, Oxygen and nitrous oxide cylinders , Disposable syringes 2ml, 5ml, 10ml, 20 ml , Emergency drugs, DC Defibrillator Eye Ointment ,ECG electrode , Syringes. Result: Intrathecal Ropivacaine- Fentanyl required more time for onset of sensory and motor block and provided lower level of sensory block with lesser duration of motor block compared to intrathecal Bupivacaine- Fentanyl. The duration of sensory block and time to request for first post operative rescue analgesia were comparable in both the groups. Conclusion: This study concludes that, freshly prepared hyperbaric ropivacaine 15 mg (of 0.75% in 5.0% dextrose) is a better alternative than hyperbaric bupivacaine (0.5%) with fentanyl for patients , who underwent, lower abdominal surgery or lower limb surgery, with faster onset and recovery from sensory and motor blocks, time needed to onset of micturition was also reduced, with better hemodynamic stability.
Authors and Affiliations
Chandra Prakash Singh, Anil Gupta
Keywords
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