B. Sridevi
BACKGROUND
Different local anaesthetics are used for epidural anaesthesia, most popular in India being lidocaine and bupivacaine. Bupivacaine is a longacting amide local anaesthetic, which is widely used for many years. However, it is associated with a number of side effects like Central Nervous System (CNS) toxicity and cardiotoxicity. Ropivacaine has been introduced recently in India and has been developed as a possible alternative to bupivacaine. It has a lower lipophilicity than bupivacaine and hence associated with a decreased potential for CNS and cardiotoxicity.
The aim of the study is to compare the time of onset of sensory and motor block, duration of sensory and motor blockade and also the haemodynamic changes produced by bupivacaine 0.5% and ropivacaine 0.75% for epidural in elective lower limb and lower abdominal surgeries.
MATERIALS AND METHODS
60 patients aged 18-55 yrs. scheduled for elective lower limb and lower abdominal surgeries belonging to ASA class I and II were given epidural anaesthesia using 15 mL of 0.5% bupivacaine (group B) and 15 mL of 0.75% ropivacaine (group R). Assessment of the sensory and motor blockade was done at intervals till maximum level achieved. Measurements of blood pressure, heart rate and arterial oxygen saturation were obtained at various time intervals. The total duration of the sensory blockade and motor blockade were also noted.
RESULTS
Our results showed no significant difference between the groups regarding sensory and motor onset time and time to attain and maximum level of sensory block. Our results also showed a significant difference in the intensity of motor blockade and the time to attain the maximum motor blockade, the total duration of analgesia and duration of motor blockade.
CONCLUSION
Hence, it is concluded that epidural ropivacaine 0.75% produces a more intense as well as prolonged motor blockade and prolonged sensory blockade than 0.5% bupivacaine. Epidural ropivacaine 0.75% can be a safe and effect alternative to bupivacaine 0.5% in lower limb and lower abdominal surgeries.
