European Journal of Molecular & Clinical Medicine

Abstract

Background and objectives: One of the most important determinants affecting the level of anaesthesia after subarachnoid block is the baricity of local anaesthetic. Hyperbaric local anaesthetic solutions are more predictable with greater intrathecal spread and less interpatient variability. This study was designed to compare these two drugs in hyperbaric forms in patients undergoing elective infraumbilical surgeries under spinal anaesthesia.
            Materials and methods:  100 patients of either sex, aged between 18 to 60 years and belonging to American society of Anaesthesiologists (ASA) physical status class I and II who were posted for various elective infraumbilical surgeries under spinal anaesthesia were randomly allocated to two groups of 50 each, to receive either 2.5 ml of 0.42% hyperbaric Levobupivacaine (group HL) or 2.5 ml of 0.42% hyperbaric Ropivacaine (group HR) intrathecally. Sensory and motor characteristics, haemodynamic parameters and adverse effects if any were recorded and data analysed with appropriate tests.
            Results: There was no statistically significant difference observed between the two groups with regards to mean time for onset of sensory and motor block (4.16±1.06 and 3.56±1.18mins in group HL vs 3.89±1.61 and 7.06± 0.99 mins in group HR). Mean time taken to achieve maximum level of sensory block and motor block were significantly shorter in group HL (7.06±1.33 and 8.81±9.0 mins) compared to group HR (10.13±2.53 and 12.91±1.48 mins). Mean time for two segment sensory regression, sensory level regression to S1, total duration of analgesia and motor block were significantly prolonged in group HL compared to group HR (109.56±12.63 vs 74.80±7.45 mins, 234.88±27.95 vs 163.16± 15.38 mins, 215.22±26.26 vs 148.34±15.73 mins and 158.16±22.7 vs 95.98±14.06 mins respectively).
            Interpretation and conclusion: Both hyperbaric Levobupivacaine and hyperbaric Ropivacaine produced reliable and adequate spinal blockade for infraumbilical surgeries without significant hemodynamic changes, however hyperbaric Levobupivacaine produced prolonged sensory and motor blockade compared to hyperbaric Ropivacaine