Haemodynamic Comparison between Isobaric Bupivacaine Fentanyl and Isobaric Ropivacaine Fentanyl for Lower Abdomoinaland Lower Limb Surgery
Lower Abdomoinal and Lower Limb Surgery
Abstract
Background: Spinal anesthesia is the most commonly used method of anaesthesia and analgesia in lower limb surgeries. Spinal anaesthesia causes more sympatholysis and haemodynamic disturbances than general anesthesia. A low dose of local anaesthetic is preferred which may occasionally cause failure of spinal anaesthesia. Therefore, different adjuvants are added to local anesthetic to achieve desired level anesthesia. Aim: The aim of this study was to compare intraoperative haemodynamic changes associated with intra thecal use of isobaric 0.5% Bupivacaine 3ml(15mg)and isobaric 0.5% Ropivacaine 3ml(15mg)both with 20 mcg(0.4ml) Fentanyl in patient undergoing lower abdominal and lower limb surgery.Subjects and Methods:100 patients were divided into two groups of fifty each. First group (Group B) was given spinal anaesthesia with 0.5% bupivacaine 3ml(15mg) with 20mcg (0.4ml) Fentanyl and second group (Group R) was given spinal anaesthesia 0.5% ropivacaine 3ml(15mg) with 20mcg (0.4ml) Fentanyl. Baseline and intra operative haemodynamic parameters; onset and duration of sensory and motor blockade were evaluated. Unpaired Students t-test and analysis of variance were applied for quantitative data and Chi - square test for qualitative data.Results:Incidence of hypotension was greater in Bupivacaine group than Ropivacaine group (p=0.001). Duration of sensory and motor blockade was less in Ropivacaine group than Bupivacaine group (p<.05).Conclusion: Ropivacaine Fentanyl provided better haemodynamic stability and shorter duration of motor block as compared to Bupivacaine Fentanyl so it is a better choice of anaesthesia in surgeries and early ambulation.