Intrathecal isobaric ropivacaine compared with hyperbaric bupivacaine for lower segment caesareansection
Journal Title: Medpulse International Journal of Anesthesiology - Year 2019, Vol 10, Issue 3
Abstract
Background: The aim of this study was to compare clinical efficacy and safety of isobaric ropivacaine and hyperbaric bupivacaine in spinal anaesthesia for elective cesarean section.Methods: A prospective, randomized study was performed in 100 patients with Term parturient measuring height of 155 to 165 cm with singleton pregnancy undergoing elective Caesarean section, randomly allocated in two groups after obtaining valid written informed/explained consent, group R (ropivacaine n=50), group B (bupivacaine n=50). Spinal anaesthesia was performed in left lateral position, with table being neutral position at the L3-L4 or L4-L5 levels and 2 ml of 0.75% isobaric ropivacaine or 0.5% hyperbaric bupivacaine was administered. Time for onset of sensory and motor block, maximum cephalad spread of sensory block, time for regression, time to request for rescue analgesia, total duration of motor block, quality of anaesthesia were assessed. Also influence of the blockade on the function of the cardiovascular and respiratory system, adverse events and requirement additional medications were recorded. All data was statistical analysed.Results: In our study, onset of sensory block at T8 was slightly prolonged with ropivacaine172.8 ± 82.7 sec compared to bupivacaine151 ± 88.30 sec, P= 0.012. Complete motor block was delayed with plain ropivacaine 498 ± 289.5sec, compared to bupivacaine, Group B- 249 ± 181.3 sec, P = 0.001. Motor block regressed faster with ropivacaine, 94.24 ± 17.58 min, compared to bupivacaine 210.62 ± 44.98 min, P = 0.001. Time of request of analgesia is comparable in both groups. Regression to L1 is shorter in case of ropivacaine 157.4 ± 34.52 min, in comparison with bupivacaine181.6 ± 43.72 min, P = 0.000Haemodynamic parameters and respiratory function were similar in both groups. Both ropivacaine and bupivacaine produced favourable surgical conditions. There were no significant differences between the groups with respect to side-effects, and additional requirement of medication and the quality of the blockade. The scores of quality of anaesthesia assessed by surgeons was similar in both groups.Conclusion: 15mg 0.75% isobaric ropivacaine provides safe and equally effective spinal anaesthesia with reduced duration of motor block, compared to 10 mg 0.5 % hyperbaric bupivacaine for cesarean section. Both provide satisfactory analgesia and good surgical conditions.
Authors and Affiliations
Madhu K R, Suresh S B
Keywords
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- EP ID EP616738
- DOI 10.26611/10151032
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