A comparative study of intrathecal isobaric ropivacaine and hyperbaric bupivacaine for elective lower segment caesarean section

Authors

  • M. Ramarao Department of Anaesthesia, Govt. Medical Collage, Rajamahendravaram, Andhra Pradesh, India
  • K. Laxman Rao Department of Anaesthesia, Govt. Medical Collage, Rajamahendravaram, Andhra Pradesh, India
  • M. Santhi Sree Department of Anaesthesia, ACSR Medical Collage, Nellore, Andhra Pradesh, India
  • M. Raghuvardhan Department of Anaesthesia, Govt. Medical Collage, Rajamahendravaram, Andhra Pradesh, India

DOI:

https://doi.org/10.18203/2319-2003.ijbcp20241647

Keywords:

Bupivacaine, Ropivacaine, Intrathecal, Caesarean section

Abstract

Background: The study was to compare intrathecal isobaric ropivacaine and hyperbaric bupivacaine in terms of onset of sensory block, maximum height of sensory block, total sensory duration, onset of motor block, degree of motor block and duration of motor block, quality of anesthesia.

Methods: The 100 cases of ASA II undergoing elective lower segment caesarean section were taken for the study and divided into two groups. Group B patients received 2 ml of hyperbaric bupivacaine intrathecally. Group R patients received 2ml of isobaric ropivacaine intrathecally. Patients were evaluated for onset and duration of sensory block, onset and duration of motor block, maximum height of sensory block, quality of anaesthesia, time to request for analgesia, hemodynamic parameters and side effects if any were studied.

Results: There were no significant differences between the two groups in mean time to onset of sensory block. Maximum sensory height attained in group B ranged between T4 and T6, where as in group R, it ranged between T2 and T6 which was clinically and statistically highly significant (p<0.001). Total duration of sensory block in group B and in group R, which is not significant (p=0.068). Mean time onset of motor block was 4min in group B and 8 min in group R, (p<0.001). Duration of motor block was 155.20±14.95 min in group B and 94.10±8.31 min group R, which is clinically and statistically significant (p<0.001).

Conclusions: Ropivacaine 15 mg (2 ml of 0.75% isobaric ropivacaine) provides comparable quality of sensory block but has slower onset and significantly shorter duration of motor block compared to bupivacaine.

References

Bonica JJ, Moore DC. Brachial plexus block anaesthesia. Curr Res Anaesth Analg. 1950;29(5):241-53.

Brown DL. Brachial plexus anaesthesia: An analysis of option. Yale J Biol Med. 1993;66:415-31.

Brown DL. Spinal block in Atlas of Regional Anesthesia, 2nd Edition, Philadelphia, WB Saunders company. 1999.

Cousins MJ, Bridenbaugh PO. Spinal neural blockade in Neural Blockade. In: Clinical Anesthesia and Management of Pain. 3rd Edition, Philadelphia, Lipponcoot-Raven. 1998.

Collins VJ. Spinal anesthesia, In: Principles of Anesthesiology-General and Regional Anesthesia, 3rd Edition Philadelphia, Lea and Febiger. 1998.

Pollock JE, Neal JM, Stephenson CA, Wiley CE. Prospective study of the incidence of transient radicular irritation in patients undergoing spinal anesthesia. Anesthesiology. 1996;84(6):1361-7.

Chung CJ, Choi SR, Kwang-Hwan Y, Han SP, Soo-Il L, Young-Jhoon C. Hyperbaric spinal ropivacaine for caesarean delivery: a comparison to hyperbaric bupivacaine. Anesth Analg. 2001;93(1):157-61.

Kallio H, Eljas-Veil TS, Sami JS, Carl AT, Mauri KI. Spinal hyperbaric ropivacaine fentanyl for day surgery. Regional Anaesth Pain Med. 2005;30:48-54.

Whiteside JB, Burke D, Wildsmith JAW. Comparison of ropivacaine 0.5% (in glucose 5%) with bupivacaine 0.5% (in glucose 8%) for spinal anaesthesia for elective surgery. Bri J Anaesth. 2003;90(3):304-8.

Boztug N, Bigat Z, Karsli B, Saykal N, Ertok E. Comparison of ropivacaine and bupivacaine for intrathecal anesthesia during outpatient arthroscopic surgery. J Clin Anesth. 2006;18(7):521-5.

Khaw KS, Kee WDN, Wong EL, Liu JY, Chung R. A Dose-finding Study of Spinal Ropivacaine for caesarean Section. Anesthesiology. 2001;95(6):1346-50.

Gautier P, De Kock M, Huberty L, Demir T, Izydorczic M, Vanderick B. Comparison of the effects of intrathecal ropivacaine, levobupivacaine, and bupivacaine for caesarean section. Bri J Anaesth. 2003;91(5):684-9.

Ogun CO, Kirgiz EN, Duman A, Okesil S, Akyurek C. Comparison of intrathecal isobaric bupivacaine-morphine and ropivacaine-morphine for caesarean delivery. Bri J Anaesth. 2003;90(5):659-64.

Garber A, Klein E, Bruce S, Sankoh S, Mohideen P. Metformin-glibenclamide versus metformin plus rosiglitazone in patients with type 2 diabetes inadequately controlled on metformin monotherapy. Diabetes Obes Metab. 2006;8(2):156-63.

O'Brien C. Drug addiction and drug abuse. In: Brunton LB, Lazo JS, Parker KL, eds. Goodman and Gilman's The Pharmacological Basis of Therapeutics. 11th ed. New York, NY: McGraw-Hill. 2005;607-29.

National Cancer Institute. Fact sheet: targeted cancer therapies, 2012. Available at: http://www.cancer.gov/cancertopics/factsheet/Therapy/targeted#q1. Accessed on 9 March 2024.

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Published

2024-06-25

How to Cite

Ramarao, M., Laxman Rao, K., Santhi Sree, M., & Raghuvardhan, M. (2024). A comparative study of intrathecal isobaric ropivacaine and hyperbaric bupivacaine for elective lower segment caesarean section. International Journal of Basic & Clinical Pharmacology, 13(4), 486–492. https://doi.org/10.18203/2319-2003.ijbcp20241647

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Original Research Articles