Comparison of Equipotent Doses of Hyperbaric Ropivacaine and Hyperbaric Levobupivacaine in Spinal Anaesthesia for Patients Undergoing Lower Abdominal and Lower Limb Surgeries
Journal Title: Indian Journal of Anesthesia and Analgesia - Year 2019, Vol 6, Issue 1
Abstract
Background: Spinal anaesthesia provides sensory as well as motor blockade. Levobupivacaine is less cardio toxic than bupivacaine, as it has decreased potency at the sodium channel. Ropivacaine is similar in chemical structure to bupivacaine, but it is less potent than bupivacaine. Intrathecal Ropivacaine is safe, has shorter duration of action than bupivacaine and lesser incidence of neurological symptoms as compared with intrathecal lignocaine. Literature suggest that potency of Ropivacaine is less when compared with levobupivacaine since it has lower lipid solubility, and thereby using an equipotency ratio of 1.5:1 between Ropivacaine and Levobupivacaine provides nearly similar efficacy outcome. Method: The study was carried out as prospective, interventional, double blind in 60 patients divided in two equal groups using equipotent doses of intrathecal hyperbaric Ropivacaine and hyperbaric Levobupivacaine (with ASA grading I and II). Results: The distribution of patients with respect to age, height, weight was statistically not significant in both the groups. (p value > 0.05). Mean time to onset of motor block was 25.07±1.97 minutes in group-L and 24.37±1.70 minutes in group-R. Average duration of motor block was 116.73±29.95 minutes in group-L and 112.93±15.40 minutes in group-R. Mean time to onset of sensory block was 17.07±1.93 minutes in group-L and 15.5 ± 1.81 minutes in group-R. Mean time to attain highest level of sensory block was 22.07±1.93 minutes in group-L and 20.5±1.81 minutes in group-R. Mean time to two segment regression of sensory block was 69±8.5 minutes in group-L and 61.83±6.31 minutes in group-R. Average duration of sensory block was 188.73±29.94 minutes in group-L and 192.2±36.01 minutes in group-R. There were no changes in vital parameters and oxygen saturation in the intraoperative and post-operative period. Mean duration of post-operative analgesia was 137.70±28.01 minutes in Group L and 131.2±38.97 minutes in Group R. Analgesic consumption for 24 hours postoperatively was similar in both the groups. It was observed that both the molecules showed similar time of onset of motor and sensory block and also nearly similar duration of motor and sensory blocks. Both the drugs were also found to be safe in terms of impact on hemodynamic parameters and no complications observed. Conclusion: Both drugs are reliable in terms of efficacy and safety and can be used interchangeably. Ropivacaine can be specifically used for population that is at higher risk of cardiac toxicity, without compromising on time of onset or duration of motor and sensory blocks.
Authors and Affiliations
Gurpreet Singh
Keywords
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- EP ID EP601101
- DOI 10.21088/ijaa.2349.8471.6119.35
- Views 113
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