A Comparative Study between Bupivacaine 0.5% and Ropivacaine 0.75% in Epidural Analgesia in Patients Undergoing Elective Lower Abdominal and Lower Limb Surgeries
Journal Title: INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY - Year 2018, Vol 6, Issue 5
Abstract
Background: Regional anesthesia is noted for its simplicity, safety, and effectiveness. Although spinal anesthesia provides an efficient block, it has some limitations. Epidural anesthesia is one of regional techniques for lower abdominal and lower limb surgeries. Bupivacaine is the drug of choice for providing effective epidural analgesia. Ropivacaine is new long-acting local anesthetic with similar chemical structure but with less cardiotoxicity and central nervous system toxicity. We did a prospective randomized control study to compare between two groups - 20 ml of 0.75% ropivacaine (isobaric) and 20 ml 0.5% bupivacaine (isobaric) for epidural anesthesia in lower abdominal and lower limb surgeries in adults aged 18–60 years. Aim: The study aimed to compare in two groups - 20 ml of 0.75% ropivacaine (isobaric) and 20 ml 0.5% bupivacaine (isobaric) for epidural analgesia in lower abdominal and lower limb surgeries in adults. Design: This was a prospective randomized control study. Methods: The study population was randomly divided into 2 groups with 30 patients in each group. Study Group R - received 20 ml of 0.75% ropivacaine (isobaric) by epidural route study Group B - received 20 ml of 0.5% bupivacaine (isobaric) by epidural route and compared (1) onset of sensory and motor block, (2) highest level of sensory block, (3) degree of motor blockade (using Modified Bromage scale), (4) duration of motor blockade, (5) duration of sensory analgesia, (6) hemodynamic changes heart rate, blood pressure, and respiratory rate, and (7) side effects if any Results: Nearly 0.75% ropivacaine has a shorter duration of motor block when compared with 0.5% bupivacaine. The onset of sensory and motor blocks, highest level of sensory block, degree of motor block, and duration of sensory analgesia are similar to that of bupivacaine. The hemodynamic changes and side effect profile of ropivacaine are also not significantly different from that of bupivacaine. Conclusion: Based on the present clinical comparative study, we conclude that ropivacaine can be used as a safe alternative to bupivacaine for epidural anesthesia in lower abdominal and lower limb surgeries. The shorter duration of motor block with ropivacaine suggest that it could be effectively used for early mobilization of patients in the post-operative period.
Authors and Affiliations
G Shravan Kumar, R Shanthan Kumar, Laxmi Kanth, M Srinath
Keywords
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