Comparative Study of Racemic Mixture of 0.5% Bupivacaine , 0.5 % Levo Bupivacaine And 0.75% Ropivacaine In Lumbar Epidural Anaesthesia In Patients Undergoing Lower Abdominal Surgeries
Study of Racemic Mixture of 0.5% Bupivacaine , 0.5 % Levo Bupivacaine And 0.75% Ropivacaine In Epidural
Keywords:
Epidural Anaesthesia; bupivacaine; levobupivacaine; RopivacaineAbstract
Background and aims: Epidural blockade is one of the most useful and versatile procedures in modern anaesthesiology. Bupivacaine a long acting amide local anaesthetic though widely used but associated with side effects like neuro and cardio toxicity. Study was done to compare the haemodynamic variations , onset time and duration of sensory and motor block and complications if any of epidural anaesthesia produced by 0.5% bupivacaine, 0.5% levobupivacaine and 0.75% r opivacaine which are possible alternatives to bupivacaine for lower abdominal surgeries. Methodology: 90 patients were randomly allocated into 3 groups of 30 each. The time for loss of pinprick at T10 and T6, intensity of motor block, duration of sensory and motor block and variations in haemodynamic parameters, respiratory rate and SpO2 changes were assessed. Results: The onset of sensory blockade at T10 level was 6.56 ± 1.69> 6.27±1.55 >6.13 ± 1.81 minutes which was comparable ,but onset of motor blockade was 18.9±2.41 >15.5+1.98 > 14±2.03 minutes in levobupivacaine, ropivacaine and bupivacaine groups respectively which was highly significant. While the duration of sensory block was 340.5±28.6 < 355.83±34.98 < 371.5 ± 9.60 minutes (P < 0.001), duration of motor block was 202.6 ±9.35 < 265.17±29.29 < 304.9 ± 28.89 minutes in bupivacaine , ropivacaine and levobupivacaine groups respectively(p < 0.001). Conclusions: Epidural levobupivacaine and ropivacaine are excellent alternatives to bupivacaine for lower abdominal surgeries with little compromise on the onset of sensory and motor block with an added advantage of longer duration as well as decreased incidence of cardiotoxicity. [Deshpande S NJIRM 2017; 8(5):22-26]
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