Comparison between Plain Ropivacaine, Ropivacaine with Buprenorphine and Ropivacaine with Clonidine for Intrathecal use in Lower Limb Orthopaedic Surgeries: A Randomised Controlled Trial

Abstract

Introduction: Ropivacaine is an amide local anaesthetic agent. The lower limb surgeries involves the great somatic pain. By using these adjuvants such as buprenorphine and clonidine with local anaesthetic agent to know the effective intraoperative and postoperative analgesia. Aim: To compare the anaesthetic characteristics in terms of quality of blockade when intrathecal ropivacaine with buprenorphine and ropivacaine with clonidine as adjuvant. Materials and Methods: The present study was a doubleblinded randomised control trial in which a total of 75 subjects were divided into three groups, with 25 per group-group R (Inj. Ropivacaine 0.75%-3 mL with 0.2 mL sterile water), group RB (0.2 mL Buprenorphine with Inj. Ropivacaine 0.75% 3 mL), and group RC (0.2 mL Clonidine with Inj. Ropivacaine 0.75% 3 mL). Onset and duration of blocks were observed. Haemodynamic parameters, and pain score were monitored intraoperatively and postoperatively. Data was entered in MS excel sheet and analysed using Statistical Package for the Social Sciences (SPSS) software version 16.0. The p-value <0.05 were considered as statistically significant. Results: The onset time of sensory and motor blockade for group RC was significantly more in comparison to R and RB groups (sensory block-5 minutes 50 seconds vs 3 minutes 39 seconds vs 3 minutes 50 seconds); and (motor block-6 minutes 52 seconds vs 4 minutes 39 seconds vs 4 minutes 74 seconds). Group RC had significantly longer duration of sensory block than R and RB groups (327 minutes 88 seconds vs 166 minutes 60 seconds (167 minutes) vs 222 minutes 44 seconds). Conclusion: Ropivacaine with clonidine showed significantly more duration of sensory block, motor block and time for first rescue analgesia with haemodynamic stability than ropivacaine and ropivacaine with buprenorphine.