Comparison of intrathecal use of isobaric and hyperbaric bupivacaine during lower abdomen surgery in I.Q City Medical College and multispeciality hospital, Durgapur, West Bengal, India.

Dr. Dilip Kumar Bhowmik; Prof. (Dr.) Mohammad Zakiuddin

Volume : IX, Issue : I, January - 2020

Comparison of intrathecal use of isobaric and hyperbaric bupivacaine during lower abdomen surgery in I.Q City Medical College and multispeciality hospital, Durgapur, West Bengal, India.

Dr. Dilip Kumar Bhowmik, Prof. Dr. Mohammad Zakiuddin

Abstract :

BACKGROUND: Bupivacaine is an amide local anaesthetic used in hyperbaric and plain forms administered as spinal anesthesia. It is the most commonly used local anaesthetic for spinal anesthesia (SA). There are two forms of commercially available bupivacaine; isobaric bupivacaine (IB): a formulation with a specific gravity or density equal to cereo spinal fluid and hyperbaric bupivacaine (HB): a formulation with density heavier than cereo spinal fluid. It is widely believed that the choice between isobaric bupivacaine and hyperbaric bupivacaine formulations alters the block characteristics for the conduct of surgery under spinal anesthesia. AIMS AND OBJECTIVE: The aim of this study was to systematically review the comparative evidence regarding the effectiveness and safety of the two formulations when used for spinal anesthesia for adult and to compare the use of isobaric and hyperbaric bupivacaine during lower abdomen surgery and their outcome. METHODS AND MATERIAL: Sixty patients who underwent lower abdominal, hips, and lower extremity surgeries were randomized into two groups. Group I received 20 mg of 0.5% isobaric bupivacaine, while Group II received 20 mg of 0.5% hyperbaric bupivacaine. Injection was made intrathecally in midline position at L3-4 interspace in sitting position. RESULT: Six patients were dropped out due to failed block and the duration of surgery being longer than 120 minutes. The remaining 54 patients (27 each groups) followed all the study procedure. Patients in both groups were comparable. Surgery lasted for 83 � 19minutes in Group I and 77 � 19 minutes in Group II (𝑃 = 0.23). CONCLUSION: Isobaric produced more rapid onset and longer duration when compared to hyperbaric bupivacaine.