Comparison of Intrathecal Hyperbaric 0.5% Bupivacaine and Isobaric 0.75% Ropivacaine in Lower Limb Orthopaedic Surgeries

Lower Limb Orthopaedic Surgeries

Abstract

Background: The study was designed to compare the efficacy of 0.75% isobaric Ropivacaine (3ml) with 0.5 % Hyperbaric Bupivacaine (3ml) in lower limb orthopaedic surgeries. Subjects and Methods: 100 patients between 18-60 years of age, of either sex, weighing 50-90 kgs, ASA- I and ASA- II, undergoing elective lower limb orthopaedic surgeries were randomly assigned into two groups-Group B -intrathecal hyperbaric 0.5% Bupivacaine (3ml=15mg) and Group R - intrathecal isobaric 0.75% Ropivacaine (3ml=22.5mg).The time of onset of sensory and motor block, time of peak sensory and motor block, two segment sensory regression, motor block duration, duration of analgesia, the maximum sensory dermatomal level and side-effects were observed. Results: The time of onset of sensory and motor block was earlier in group B compared to Group R(p<0.001). The time of peak sensory and motor block was earlier in group B compared to group R (p<0.001). The heart rate, SBP and DBP were statistically insignificant between the two groups (p>0.05). The two dermatomal sensory regression of B group was significantly prolonged compared to group R (p=0.0206). The total duration of motor block and sensory was significantly prolonged (p<0.001) in group B. 30 patients (60%) of B group and 36 patients (72%) of R group showed a maximal sensory dermatomal level of T6. 8 patients (16%) of group B and 10 patients (20%) of group R showed a maximal sensory dermatomal level of T4. Five patients in group B had bradycardia (p<0.05). Add this new sentence in between. Seven patients in group B and one in group R had hypotension (p<0.05). Three patients in group B had vomiting (p>0.05). Conclusion: Ropivacaine produced satisfactory anaesthesia. Ropivacaine took a longer time to 'fix' to cause sensory and motor blockage. The lessor duration of the motor block of ropivacaine is desirable. Patient in Ropicaine group showed higher proportion of maximum level of sensory analgesia and lesser incidences of hypotension and bradycardia.