A prospective, comparative, observational study of quality of spinal anaesthesia with 0.5% and 0.75% plain isobaric ropivacaine in lower abdomen and lower limb surgeries

2016-07-15T07-16-02Z
Source: International Journal of Research in Medical Sciences
Hema B. Gupta, Sumit N. Amilkanthwar.
Background: Spinal anaesthesia or subarachnoid block remains one of the basic techniques in the arsenal of modern anaesthesiology. Aim of the study was to evaluate and compare quality of spinal anaesthesia with isobaric 0.5% and 0.75% intrathecal ropivacaine in patients undergoing lower abdominal and lower limb surgeries. Methods: 100 patients between 18 and 60 years, of either gender belonging to ASA class I or II, posted for elective lower abdominal and lower limb surgeries, planned under spinal anaesthesia using ropivacaine. Patients were grouped as group A: 3 ml (15 mg) of 0.5% plain ropivacaine and Group B: 3ml (22.5mg) of 0.75% plain ropivacaine. Parameters observed were onset and duration of sensory and motor block, maximum sensory level achieved degree of motor blockade, two segment regression, and haemodynamic changes. Results: No significant differences were noted in Mean time for onset and time to achieve maximum level of sensory and motor blockade in both groups. Maximal dermatomal level was T10 in group A and T8 in group B which was statistically significant. Also, 96% patients had grade III motor blockade in group B as compared to 80% in group A which was statistically significant. Significant differences were noted in Time for two segment regression (92.56±11.846 minutes in group A and 137.3±13.06 min in group B), the duration of sensory blockade (184.5±18.385 min in group A and 238.8±19.260 min in group B) and duration of motor blockade (120.3±15.59 min in group A and 178.8±16.053 min in group B). Conclusions: Intrathecal isobaric ropivacaine 0.5% and 0.75% are safe and effective with minimal intraoperative and postoperative side effects. Recommended for short duration orthopaedic and lower abdominal surgeries where prolonged motor blockade is undesirable.


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