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Indian Journal of Anesthesia and Analgesia

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Evaluation of Hyperbaric Intrathecal Ropivacaine and Levobupivacaine versus Racemic Bupivacaine in Patients with Infra-Umbilical Surgery: A Comparative Study

Sachin Ramesh Totawar, Associate Professor, Dept. of Anaesthesiology, Dr. Shankarrao Chavan Govt. Medical College, Nanded, Maharashtra 431606, India. , Swapnil Dattatray Deshmukh1 , Sachin Ramesh Totawar2

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Indian Journal of Anesthesia and Analgesia 4(3):p 689-694, July - September 2017. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4317.24

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Abstract

Introduction: Spinal anaesthesia is popular anaesthetic technique for lower abdominal and lower extremity surgery. Lidocaine and bupivacaine has been commonly used as anaesthetic agents. Ropivacaine had been found to be relatively cardiostable. Levobupivacaine is a long-acting local anaesthetic. Hyperbaric solutions of local anaesthetics, were compared to isobaric ones, were faster in onset of sensory and motor block, and improved quality of anaesthesia. Aim and Objectives: To evaluate the efficacy of hyperbaric intrathecal ropivacaine, and levobupivacaine versus racemic bupivacaine, for spinal anaesthesia in patients admitted for infra-umbilical surgeries. Material and Methods: The present randomized control study was carried out between Jan. 2013– Dec. 2013, on 120 patients admitted for elective infra-umbilical surgeries. The patients were allocated to three groups: Group I: Bupivacaine 0.5%, 15 mg (3 ml), Group II: Ropivacaine 0.75%, 22.5 mg (3 ml) + 0.5 ml, 25% dextrose, and Group III: Levobupivacaine 0.5%, 15 mg (3 ml) + 0.5 ml, 25% dextrose =3.5 ml. Results: Onset of sensory block was significantly faster with levobupivacaine onset to T10 in 1-2 minutes and 67.5% in 3-4 minutes than bupivacaine than ropivacaine. Level and time required for sensory block was similar with all three drugs. In group I mean time of maximum level of analgesia was 17.12±3.5607 minutes, In group II mean time was 17.47±5.4935 minutes and in group III was 17.10±4.5487 minutes. Onset of motor block was faster with levobupivacaine and bupivacaine than ropivacaine. Mean and SD of time of motor onset in groups I, II and III is 6.125±1.265 minutes, 7.275±1.585 minutes and 5.475±1.086 minutes respectively. Degree of motor block as well as quality of anaesthesi was similar in the three treatments. Conclusion: Intrathecal ropivacaine produced a shorter duration of motor and sensory block. Hyperbaric levobupivacaine was more haemodynamically stable.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4317.24

Keywords

Ropivacaine; Levobupivacaine; Infraumbilical; Spinal Anesthesia. 

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