Comparison of Intrathecal Ropivacaine  with Fentanyl and Bupivacaine with  Fentanyl for Urological Surgery

Dr.Bipin J.Ganvit; Dr.Parimal H. Patel; Dr.Hitesh  R. Ahir

Volume : II, Issue : XII, December - 2013

Comparison of Intrathecal Ropivacaine with Fentanyl and Bupivacaine with Fentanyl for Urological Surgery

Dr. Bipin J. Ganvit, Dr. Parimal H. Patel, Dr. Hitesh R. Ahir

Abstract :

Introduction: Bupivacaine was the first long acting amino-amide local anaesthetic agent being used and ropivacaine is the pure (S-isomer) enantiomer of bupivacaine. Ropivacaine, s-enantiomer of amide local anaesthetic produces differential neural blockade with less motor blockade, cardiovascular and neurological toxicity makes it suitable for day care surgery. Aim: To evaluate the efficacy and safety of Isobaric ropivacaine 0.75% when compared to Isobaric bupivacaine0.5% and addition of fentanyl 20mcg to provide operative anaesthesia in endoscopic urological surgeries Material and Methods: In duration of three year (2010 to 2013) the study was randomized and double blinded, conducted in 120 adult patients scheduled for endoscopic urological surgery using spinal anaeshthesia. Anaesthtic agent uses were Inj Isobaric Ropivacaine 0.75% vial & Inj Fentanyl ampoule ( group R+F) in 60 patients and Inj Isobaric Bupivacaine 0.5% vial & Inj Fentanyl ampoule ( group B+F) in other 60 patients. All patients were examined for sensory and motor block was assessed at time intervals. Sensory block was assessed by using pin prick on each side of midthoracic line, and patients were asked about sensation at the site of surgery.The motor block was assessed by modified omage score. Result: There was no significant difference in the duration of surgery. No. of URS surgery are more in group-R+F as compared to group-B+F & No of TURP -TURBT are more in group-B+F as compared to group-R+F. There was no statically significant difference in the onset time of sensory block in both groups. The median duration of sensory block at the T10 dermatome was significantly longer in B+F group. Onset of motor block was same in both groups. The median duration of complete motor block (modified omage scale 3) was significantly shorter in the R+F group and after immediate postoperative period, the degree of motor block was lower in the R+F. Conclusions: Ropivacaine with Fentanyl found to be better combination for urological surgeries as an adjuvant to general anaesthesia or sole technique with chances of less complication with high success rate.