A Comparison of 0.2% Ropivacaine with 0.25% Bupivacaine for Paediatric Lumbar Epidural Block

Prof. Dr. C. Anuradha; Dr. Lakshmi Prakash

Volume : VI, Issue : IX, September - 2016

A Comparison of 0.2% Ropivacaine with 0.25% Bupivacaine for Paediatric Lumbar Epidural Block

Prof. Dr. C. Anuradha, Dr. Lakshmi Prakash

Abstract :

Bupivacaine has been a widely used local anaesthetic drug for caudal and lumbar epidural analgesia, but Alight2, in 1979, published an alarming editorial which associated the long–acting local anaesthetics – Bupivacaine and Etidocaine with cardiac arrest. This led to the synthesis of Ropivacaine, a new amino–amide local anaesthetic with less motor block, less cardiotoxicity and the same duration of analgesia in comparison to Bupivacaine. Our study is an open, randomized double blind prospective study involving a random group of 40 children in the age group of 4 to 12 years scheduled to undergo elective abdominal surgery below the sensory level of T6. The children were assigned randomly to one of the two groups. Group B received Bupivacaine 0.25% at 0.7 ml/kg while Group R received Ropivacaine 0.2% at 0.7 ml/kg through the lumbar epidural route. The present study was designed to compare the hemodynamic changes, duration of analgesia, motor blockade and, to evaluate the factors of efficacy, safety of 0.2% Ropivacaine with 0.25% Bupivacaine administered via lumbar epidural route in combination with light general anaesthesia in children undergoing major abdominal surgery. Findings (Results): In this study, the following were the findings in terms of the duration of sensory analgesia and motor blockade. Mean duration of sensory analgesia was as follows: • For Bupivacaine – 352.95 ± 23.46 min • For Ropivacaine – 346.55 ± 22.62 min This was statistically, Not Significant. Duration of motor blockade was as follows: • For Bupivacaine – 181.45 min ± 16.285 min • For Ropivacaine – 132.05 min ± 09.757 min This is statistically Significant. This serves to conclude that Ropivacaine has a comparable duration of sensory analgesia to Bupivacaine with a significantly shorter duration of motor blockade and no significant hemodynamic changes.