Plain versus Hyperbaric Solutions of 0.75% Ropivacaine in Spinal Anaesthesia in Elective Lower Abdominal and Lower Limb Surgeries: A Randomized Comparative Clinical Study
Authors/Creators
- 1. Assistant Professor, Department of Anesthesiology, Jawaharlal Nehru Medical College & Hospital, Bhagalpur, Bihar, India
- 2. Senior Resident, Department of Anesthesiology, Jawaharlal Nehru Medical College & Hospital, Bhagalpur, Bihar, India
Description
Aim: This study was designed to compare the clinical efficacy of plain and hyperbaric solutions of 0.75% ropivacaine in spinal anaesthesia in elective lower abdominal and lower limb surgeries. Methods: The present study was conducted in the Department of Anesthesiology, Jawaharlal Nehru Medical College & Hospital, Bhagalpur, Bihar, India for one year and Fifty ASA grade I–II patients who were to undergo elective lower abdominal and lower limb surgeries under spinal anaesthesia gave written informed consent to take part in the study, which was approved by the local research ethics committee. Results: In the study, the mean specific gravity of the freshly prepared hyperbaric ropivacaine 0.75% solution (by the addition of 50 mg/mL dextrose) observed was 1.148 and plain ropivacaine 0.75% was 1.160. The two groups were comparable with regard to age, sex, height, weight, ASA status, and types of surgeries and the mean difference was statistically not significant. Hyperbaric ropivacaine produced a more rapid onset of more extensive, but less variable sensory block, which, nonetheless, ultimately regressed more quickly. The onset of analgesia to pinprick at T10 was more rapid, and the maximum block height (median T4 vs T8) was greater, but less variable. Median time to maximum block height was the same in both groups, but the range was considerably greater with the plain solution. The onset of lower limb motor block was slightly faster in the hyperbaric group, but the maximum degree obtained was the same in both groups. Conclusion: Addition of glucose 50 mg /ml to ropivacaine 5 mg /ml increases the speed of onset, block reliability, duration of useful block for perineal surgery, and speed of recovery. Plain solutions are less reliable for surgery above a dermatomal level of L1.
Abstract (English)
Aim: This study was designed to compare the clinical efficacy of plain and hyperbaric solutions of 0.75% ropivacaine in spinal anaesthesia in elective lower abdominal and lower limb surgeries. Methods: The present study was conducted in the Department of Anesthesiology, Jawaharlal Nehru Medical College & Hospital, Bhagalpur, Bihar, India for one year and Fifty ASA grade I–II patients who were to undergo elective lower abdominal and lower limb surgeries under spinal anaesthesia gave written informed consent to take part in the study, which was approved by the local research ethics committee. Results: In the study, the mean specific gravity of the freshly prepared hyperbaric ropivacaine 0.75% solution (by the addition of 50 mg/mL dextrose) observed was 1.148 and plain ropivacaine 0.75% was 1.160. The two groups were comparable with regard to age, sex, height, weight, ASA status, and types of surgeries and the mean difference was statistically not significant. Hyperbaric ropivacaine produced a more rapid onset of more extensive, but less variable sensory block, which, nonetheless, ultimately regressed more quickly. The onset of analgesia to pinprick at T10 was more rapid, and the maximum block height (median T4 vs T8) was greater, but less variable. Median time to maximum block height was the same in both groups, but the range was considerably greater with the plain solution. The onset of lower limb motor block was slightly faster in the hyperbaric group, but the maximum degree obtained was the same in both groups. Conclusion: Addition of glucose 50 mg /ml to ropivacaine 5 mg /ml increases the speed of onset, block reliability, duration of useful block for perineal surgery, and speed of recovery. Plain solutions are less reliable for surgery above a dermatomal level of L1.
Files
IJPCR,Vol15,Issue1,Article78.pdf
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Additional details
Dates
- Accepted
-
2023-01-09
Software
- Repository URL
- https://impactfactor.org/PDF/IJPCR/15/IJPCR,Vol15,Issue1,Article78.pdf
- Development Status
- Active
References
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