COMPARATIVE EVALUATION OF INTRATHECAL ADMINISTRATION OF ROPIVACAINE, LEVOBUPIVACAINE AND BUPIVACAINE IN PATIENTS UNDERGOING LOWER LIMB SURGERIES

Abstract

Introduction: Subarachnoid block is probably the most widely used regional anesthetic
procedure in routine clinical anesthesiology practice. It provides rapid onset, consistent sensory blockade and adequate muscle relaxation for all types of surgery below the level of umbilicus. This procedure is relatively easier, requires less equipment and very cost effective.
Materials and Methods: After obtaining informed consent from all the patients, Seventy five
patients of ASA I and II of age 50 to 70 years of either sex were included in our study. These
patients were divided equally into 3 Groups, 50 each. Group I, II and III who received intrathecal 3 ml 0.5% isobaric Bupivacaine (15 mg), 3 ml 0.5% isobaric Ropivacaine (15mg) and 3 ml 0.5% isobaric Levobupivacaine (15 mg) respectively. Patients who refuse for consent, Infection at site of injection, Coagulopathy or any other bleeding disorder, severe Hypovolemia, severe hypotension, increased intracranial tension, severe stenotic valvular heart disease or ventricular outflow obstruction were excluded from our study.
Results: In our study p-value was found to be insignificant regarding age and duration of surgery among all three groups. The mean age of the patients in Group I was 35.125 ± 7.4 years, in the Group II was 34.2± 9.0 years in the group III was 34.9 ± 8.0 years and p value was found to be insignificant. The mean onset of sensory block for Bupivacaine 0.5% plain was 6.30±1.20 mins for Ropivacaine 0.5% plain was 6.12±1.00 mins and for Levobupivacaine was 6.25±1.10 mins which was statistically insignificant. The level of sensory block in Group I is Thoracic level 9, in Group II it is Thoracic level 10 & group III is Thoracic level 10. P value is > 0.05, so there is no significant difference in level of sensory block between the three groups.
Conclusion: It was found that Ropivacaine 0.5% intrathecally provides shorter duration of motor & sensory block compared to Bupivacaine 0.5% & Levobupivacaine 0.5%. Also there were less episodes of hypotension which indicate that 0.5% Ropivacaine & 0.5 Levobupivacaine provides more hemodynamic stability than Bupivacaine 0.5% intrathecally.