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A Comparative Study of Intrathecal Isobaric 0.5% Ropivacaine with Isobaric 0.5% Bupivacaine in Elective Lower Abdominal and Lower Limb Surgeries

Sandhya Gujar, Professor & Head, Department of Anaesthesiology, ESI ­Post Graduate Institute of Medical Science & Research (ESI­PGIMSR) & Model Hospital, Andheri, Mumbai, Maharashtra 400093, India. , Sandhya Gujar1 , Houkip2

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Indian Journal of Anesthesia and Analgesia 5(10):p 1694-1701, Oct 2018. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.51018.17

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Abstract

  Ropivacaine has a lower and different toxicity profile compared to Bupivacaine. It is a new long­acting, enantiomerically pure (S­enantiomers), amide local anaesthetic with a high pKa and low lipid solubility. T. Ropivacaine has a greater degree of motor sensory differentiation, which could be useful when motor blockade is undesirable. The reduced lipophilicity is also associated with decreased potential for central nervous system toxicity and cardio toxicity. Ropivacaine should be a favorable local anesthetic for day­case surgery and could be associated with earlier postoperative mobilization than Bupivacaine. Objective of Study: To compare the effects of intrathecal hyperbaric 4 ml of 0.5% Ropivacaine with 4 ml of hyperbaric 0.5% Bupivacaine in a ratio of 1:1 by volume (Ropivacaine 16.5 mg and Bupivacaine 11 mg) for lower abdominal/lower limb orthopedic surgeries with regard to: Onset and duration of sensory block, motor block. Maximum height of sensory block. Quality of anesthesia and Adverse reactions if any after taking written informed consent. Observations: Onset of motor blockade was slower and duration of motor blockade was shorter with Ropivacaine compared to Bupivacaine. However, all the patients in either groups attained complete motor blockade. With respect to hemodynamic parameters intrathecal Ropivacaine provided a higher Degree of cardiovascular stability with a lesser incidence of hypotension and bradycardia was observed. Result: There is delayed onset of motor block and shorter duration of motor block with Ropivacaine compared to Bupivacaine. Cardiovascular stability is better than Bupivacaine. Hence, Ropivacaine can be used successfully for lower limb/abdominal surgeries where early recovery is well appreciated by the patients

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.51018.17

Keywords

Ropivacaine; Buphivacaine; Lower Limb Surgeries

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