Comparison between intrathecal isobaric levobupivacaine-fentanyl and isobaric ropivacaine-fentanyl in elective lower abdominal and lower limb surgeries: A randomized controlled study

Wasimul Hoda; S.N Roy

Volume : VIII, Issue : II, February - 2019

Comparison between intrathecal isobaric levobupivacaine-fentanyl and isobaric ropivacaine-fentanyl in elective lower abdominal and lower limb surgeries: A randomized controlled study

Wasimul Hoda, S. N Roy

Abstract :

Background: We aimed to evaluate the clinical efficacy of intrathecal isobaric ropivacaine-fentanyl and isobaric levobupivacaine-fentanyl combination in elective lower abdominal and lower limb surgeries. Methods: A Prospective randomized controlled double blind study was done in 68 adult posted for elective lower abdominal and lower limb surgeries under spinal anaesthesia. They were given either 3 ml 0.5% isobaric Levobupivacaine and 25 mcg fentanyl (Group A) or 3 ml 0.5% isobaric ropivacaine and 25 mcg fentanyl (Group B). Onset, duration of sensory and motor blocks, time for maximum sensory and motor block, time for 2 segment sensory regression, analgesia and haemodynamic parameters were recorded and analyzed.Results: All patients achieved a sensory block of T10 dermatome. Onset of sensory blockade at T10 was similar in both groups, Group A (5.01 �1.21 min) and Group B (5.41�1.63 min). Time from injection to two dermatomal regression was 174.38�15.72 min in Group A and 169.24�14.03 min in Group B. Onset of Bromage score of 1 in Group A was 3.68�1.27 min and in Group B was 5.44�1.64 min. The mean duration of motor and complete motor block was prolonged in Group A patients (201.74�18.51min, 188.82�16.90 min) as compared to Group B (152.88�20.41 min, 126.71�11.85 min). The mean duration of analgesia (345.54�15.45 min vs. 225.15� 20.35 min) was significantly higher in the levobupivacaine-fentanyl group. Conclusions: Intrathecal isobaric levobupivacaine-fentanyl combination produces a significantly longer duration of analgesia, sensory block and motor block than isobaric ropivacaine-fentanyl combination. Ropivacaine with fentanyl can be considered in day care surgery as it has shorter duration of sensory and motor block, early ambulation with good analgesia