Comparison of Onset and Duration of Motor Block and Hemodynamic Stability after Epidural Block using Ropivacaine and Bupivacaine for Lower Limb Surgeries
Journal Title: International Journal of Contemporary Medical Research - Year 2017, Vol 4, Issue 7
Abstract
Introduction: The routine use of parenteral opioids is still inadequate for postoperative pain control and may further aggravate the unpleasant side effects like nausea vomiting, sedation, urinary retention and depressed ventilation. Epidural block is a commonly used alternative for general anaesthesia in case of orthopaedic surgeries. Bupivacaine & Ropivacaine are amide local anaesthetics. The present study is being undertaken to compare the efficacy of conventional Bupivacaine 0.5% with newer Ropivacaine 0.75% via lumber epidural block for lower limb orthopaedic surgery. Material and methods: The present prospective randomised study was conducted in Department of Anaesthesiology, Gandhi Medical College and associated Hamidia Hospital, Bhopal (M.P.). In this study patients aged between 20-50 years belonging to ASA grade I and II were included in the study. 50 patients who went for elective lower limb surgery were included in the study. Under complete aseptic condition, epidural catheter was inserted in L2-L3lumbar space. Drug was given epidurally with patient lying in supine position. Continuous monitering of B.P.,HR,R/R, SpO2 and ECG was taken during intra operative period at regular intervals. Onset of motor blockade was noted in all the patients using Bromage Scale. Postoperative H.R., B.P., R/R, SpO2 and ECG was observed up to the required of 1st rescue analgesic dose. The obtained data was arranged in a tabulated form. SPSS software was used for analysis of the data. Chi square test was applied as the test of significance and p value of less than 0.05 was considered significant. Results: The mean duration of onset of motor block for Group I was 25± 4.4 mins while for Group II it was 26.3±4.8 26.3±4.8 mins. P-value for both group is > 0.05, so there is statistically no difference between two Groups. The mean duration of motor blockade in group I was 264.4± 24 mins, while it was258.5±28 mins in Group II Conclusion: The duration of motor blockade was shorter with 0.75% Ropivacaine compared to 0.5% Bupivacaine when given via lumber epidural. The lumber epidural anaesthesia with 0.75% Ropivacaine provided more hemodynamic stability than 0.5% Bupivacaine.
Authors and Affiliations
Abhijeet Patil
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