A comparative study of spinal anesthesia with hyperbaric ropivacaine plus dexmedetomidine and hyperbaric bupivacaine plus dexmedetomidine in lower abdominal and lower limb surgeries
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 4, Pages 3856-3865
AbstractAims: The aim of the study is to compare the onset, duration of sensory and motor block, and hemodynamic changes between equipotent doses of 0.75% Ropivacaine H with dexmedetomidine & 0.5% Bupivacaine H with dexmedetomidine.
Materials and Methods: This was a comparative study conducted on ASA grade I and II patients, aged between 18 and 60 years, scheduled for elective lower abdominal and lower limb surgeries. Minimum of 60 patients, divided into two groups, Group R, and Group B (30 patients in each Group). Group R patients received hyperbaric ropivacaine 0.75% 3cc + 10 mcg dexmedetomidine and Group B patients received hyperbaric bupivacaine 0.5% 3cc + 10 mcg dexmedetomidine. Monitoring of vitals and observation for the block parameters were carried out and compared. Categorical data are compared using the Chi-Square test. Continuous variables are compared using a student t-test. P-value < 0.05 is considered significant.
Results: Time taken for sensory onset, maximum sensory block, and complete motor block was faster in group B. Time taken for sensory regression to S1 and duration of motor block was longer in group B. However, subjects in group B experienced lesser mean systolic, diastolic, and mean arterial pressures when compared to group R. Duration of sensory and motor block was increased with the addition of adjuvant Dexmedetomidine.
Conclusion: Spinal anesthesia with intrathecal 0.75% Ropivacaine H with dexmedetomidine has characteristically delayed onset, with a shorter duration of action on the sensory as well as motor nerve roots when compared to 0.5% Bupivacaine H with dexmedetomidine. Complications like hypotension and bradycardia were less in the Ropivacaine group. Compared to the bupivacaine group, better alternative for spinal anesthesia in the geriatric population. With a shorter recovery profile, Ropivacaine is a useful agent for Spinal Anesthesia for the intermediate duration of surgeries and for ambulatory surgeries.
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