Comparison Of Onset And Duration Of Blockade Between Equal Doses Of Isobaric Levobupivacaine 0.5% -Fentanyl And Isobaric Ropivacaine 0.5%-Fentanyl In Lower Abdominal Surgeries Under Spinal Anaesthesia - A One Year Hospital Based Randomised Clinical Trial

Abstract

Background and Objective Spinal anaesthesia is the most convenient anaesthetic technique for lower abdominal surgeries that offers many advantages over general anaesthesia, including reduced stress response and improved post-operative pain relief. Levobupivacaine and ropivacaine have been described as alternatives to bupivacaine for spinal anaesthesia. Fentanyl is a commonly used adjuvant. The present study was done to evaluate onset and duration of sensory and motor block between 3.0 ml of 0.5 % isobaric levobupivacaine + 0.5 ml (25mcg) fentanyl and 3.0 ml of 0.5 % isobaric ropivacaine + 0.5 ml (25 mcg) fentanyl in lower abdominal surgeries. Methods This one year randomized controlled trial was conducted in the Department of Anaesthesiology, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belagavi during the period January 2014 to December 2014. A total of 80 patients undergoing lower abdominal surgeries under spinal anaesthesia were allocated into two groups namely, Group LF ( n =40 , Patients received 3.0 ml of 0.5 % isobaric levobupivacaine + 0.5 ml ( 25mcg ) fentanyl intrathecally) or Group RF ( n =40 , Patients received 3.0 ml of 0.5 % isobaric ropivacaine + 0.5 ml ( 25 mcg ) fentanyl intrathecally ) Results In this study demographic parameters were comparable in both the groups. The onset of sensory block was significantly faster in Group RF (5.25 ± 0.74 min ) than in Group LF ( 6.53 ± 0.51 min ).The duration of sensory block was significantly longer in Group LF ( 169.5 ± 7.15 min ) than in Group RF (144.25 ± 5.94 min). The onset of motor block was significantly faster in Group RF (7.25 ± 0.98 min) than in Group LF (11.2 ± 0.61 min). The duration of motor block was significantly longer in Group LF (219.5 ± 6.39 min) than in Group RF (171.25 ± 7.23 min). Hemodynamic parameters were comparable between the two groups with no major side effects / complications observed. Conclusion and interpretation Overall, based on the findings of this study it may be concluded that intrathecal 0.5 % isobaric levobupivacaine - fentanyl is more potent than intrathecal 0.5 % isobaric ropivacaine - fentanyl with respect to the duration of sensory and motor block with no significant hemodynamic changes. Both the drugs can be used as alternative to bupivacaine intrathecally with no risk of major side effects / complications.