Comparing the efficacy and haemodynamic response between intrathecal hyperbaric 0.5% bupivacaine with isobaric 0.75% ropivacaine using fentanyl as adjuvant in patients undergoing infra umbilical surgeries

Abstract

Central neuraxial blockade is the most widely used form of regional anesthesia in surgeries involving abdominal, urological, obstetric, gynaecological and lower limb. The nerve blocking properties of the R and S-enantiomers were similar but that the S-enantiomer was less cardiotoxic. The aim of our study is to compare the efficacy and haemodynamic response between intrathecal hyperbaric 0.5% Bupivacaine with isobaric 0.75% Ropivacaine using Fentanyl as adjuvant in patients undergoing infra umbilical surgeries. 60 patients of age group between 25 – 65 years belonging to American Society of Anaesthesiologist (ASA) 1 and 2 posted for general surgical, urological, orthopaedic and gynaecological procedures involving lower abdominal surgeries under spinal anaesthesia divided into two groups of 30 each and randomly allocated to one of the two below mentioned groups: Bupivacaine group (Group B) n=30; Ropivacaine group (Group R) n=30 Chi-square test and Student’s ‘t’ test were used to analyse the results. The sensory block in Bupivacaine group B was significantly higher compared to Ropivacaine group R attaining statistical significance. The 3 minutes motor block, incidence of hypotension was denser and higher in Bupivacaine group compared with Ropivacaine group. Incidence of bradycardia was not significantly different between the two groups.Although the onset of motor blockade was denser in Bupivacaine group, the total duration of motor blockade was similar between the groups. We conclude from our study that 0.75% isobaric Ropivacaine produces similar duration of efficacy with stable haemodynamics, as compared with 0.5% hyperbaric Bupivacaine.