Intrathecal 0.75% Isobaric Ropivacaine Versus 0.5% Heavy Bupivacaine For Elective Caesarean Delivery: A Randomized Comparative Study In Hundred Patient’s
Intrathecal 0.75% Isobaric Ropivacaine Versus 0.5% Heavy Bupivacaine
Keywords:
Ropivacaine, Bupivacaine, intrathecal, caesarean sectionAbstract
Background And Aim: Ropivacaine being comparatively less cardiotoxic and neurotoxic than bupivacaine, it also produces minimal motor blockade of shorter duration when used in spinal anaesthesia. This study was aimed to compare the intrathecal 0.75% isobaric ropivacaine for caesarean delivery with 0.5% bupivacaine heavy in pregnant patients. Method: 100 parturient belonging to ASA grade I & II scheduled for elective caesarean section were randomly selected for the study and are divided into two groups of 50 each. Group B patients received 2ml of 0.5% hyperbaric Bupivacaine intrathecally. Group R patients received 2ml of 0.75% isobaric Ropivacaine intrathecally. Onset and duration of sensory block, onset and duration of motor block, highest level of sensory block, quality of anaesthesia, and time of request for analgesia, hemodynamic parameters and adverse effects if any were studied. Results: Baseline demographic variables were similar in two groups. Neonatal outcome were also similar in two groups. Onset of sensory block at T8, time to request for analgesia, total duration of analgesia was comparable in both groups. Mean highest level of sensory block in both groups was T5 but in group R having slightly higher range (T3-T6) as compare to group B (T4-T6). Regression of sensory block at L1, duration of motor block was shorter but having longer onset of motor block in Group R as compare to group B. Conclusion: Ropivacaine 15 mg (2 ml of 0.75% isobaric Ropivacaine) provides comparable quality of sensory block but has slower onset and significantly shorter duration of motor block compared to bupivacaine. [Tudu L NJIRM 2014; 5(6) :44-48]
References
2. Pollock JE, Neal JM, Stephenson CA, Wiley CE. Prospective study of the incidence of transient radicular irritation in patients undergoing spinal anesthesia. Anesthesiology 1996 ; 84 :1361-7.
3. Moller RA, Covino BG. Cardiac electrophysiologic properties of bupivacaine and lidocaine compared with those of ropivacaine, a new amide local anesthetic. Anesthesiology 1990 ; 72: 322–9. 4. Graf BM, Abraham I, Eberbach N, Kunst G, Stowe DF, Martin E. Differences in cardiotoxicity of bupivacaine and ropivacaine are the result of physicochemical and stereoselective properties. Anaesthesiology 2002; 96:1427–34.
5. Scott DB, Lee A, Fagan D, et al. Acute toxicity of ropivacaine compared with that of bupivacaine. Anesth Analg 1989; 69:563–9.
6. Gautier, M De Kock, L Huberty, T Demir, M Izydorczic and B Vanderick. Comparison of the effects of intrathecal ropivacaine, levobupivacaine and bupivacaine for Caesarean section. British Journal of Anaesthesia 2003; 91 : 684-689.
7. Danelli G, Fanelli G, Berti M, Cornini A, Lacava L, Nuzzi M, Fanelli A. Spinal ropivacaine or bupivacaine for caesarean delivery : A prospective randomized double blind comparison. Reg Anesth Pain Med 2004; 29: 221-6.
8. Ogun C.O, Kirgiz E.N, Duman A, Okesil S, Akyurek C. Comparison of intrathecal isobaric bupivacaine morphine and ropivacaine morphine for Caesarean delivery. British journal anaesthesia 2003; 90: 659-664.
9. Bernard Rosner. In: Fundamentals of Biostatistics. 5th Edition. 2000: 80.
10. Sunder Rao P S S , Richard J: An Introduction to Biostatistics. In: A manual for students in health sciences. Prentice hall of India, New Delhi. 1996: 86-160
11. Chan-Jong Chung, So-Ron Choi, Kwang-Hwan Yeo, Han Suk Park and, Soo-Il Lee and Young- Jhoon Chin. Hyperbaric spinal ropivacaine for caesarean delivery: A comparison to hyperbaric bupivacaine. Anesthesia and analgesia 2001; 93:157-161.
12. J B Whiteside, D Burke, and J A W Wildsmith. Comparison of ropivacaine 0.5% in glucose 5% with bupivacaine 0.5% in glucose 8% for spinal anaesthesia for elective surgery. British Journal of Anaesthesia 2003; l. 90: 304-308.
13. Neval Boztug, Zekiye Bigat, Bilge Karsli, Nurdan Saykal, Ertugrul Ertok. Comparison of ropivacaine and bupivacaine for intrathecal anesthesia during outpatient arthroscopic surgery. Journal of Clinical Anaesthesia 2006; 18: 521–525.
14. Kim S. Khaw et al. A Dose-finding Studyof Spinal Ropivacaine for Caesarean Section 2001; 95:1346–50.
15. Gautier, M De Kock, L Huberty, T Demir, M Izydorczic and B Vanderick. Comparison of the effects of intrathecal ropivacaine, levobupivacaine and bupivacaine for Caesarean section. British Journal of Anaesthesia 2003; 91 : 684-689.
