Study of Post-Operative Analgesic Effect Using Plain Ropivacaine & Ropivacaine Combined with Epinephrine as Intraperitoneal Instillation & Incisional Infiltration in Caesarean Section Patients
European Journal of Molecular & Clinical Medicine,
2023, Volume 10, Issue 3, Pages 1545-1552
AbstractCaesarean section commonly induces moderate to severe pain lasting 48 hours after surgery. Prompt and adequate post-operative pain relief is an important component of caesarean delivery that can make the period immediately after the operation less uncomfortable as well as mother can initiate early breastfeeding that helps to contract the uterus and accelerates the process of uterine involution in the postpartum period. Various clinical studies have shown that ropivacaine is equal to bupivacaine in local anesthetic potency and is less toxic than bupivacaine in regard to the production of mild central nervous system and cardiovascular toxicity. Methodology- The study was carried out a tertiary care center on patients fulfilling the inclusion and exclusion criteria. Patients were randomly allocated in two groups i.e, Group A & Group B consisting of 50 patients in each. Spinal anaesthesia was performed at L3-L4 with 8–10 mg of a hyperbaric bupivacaine 5 mg/mL solution. Intraperitoneal instillation and incisional infiltration with 30 mL of 0.25% ropivacaine was performed in Group A. Intraperitoneal instillation and incisional infiltration with 30 mL of 0.25% ropivacaine plus epinephrine (5mics) (1:2,00,000) was given in Group B. The haemodynamic monitoring was done at every 15 mins in first hour of skin closure, in the recovery room, then at 2 hours, 4 hours, 6 hours, 8 hours, 12 hours and 24 hours after closure of the skin measuring heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and SPO2. Results- In both the groups, study drugs prolonged the duration of analgesia for similar duration in post-operative period. Hence, there is no difference between duration of analgesia provided by the study drugs post-operatively in both the groups and is statistically non-significant since p>0.05. Conclusion- 0.25% plain ropivacaine 30 ml and 0.25% Plain ropivacaine 30 ml plus epinephrine (1:2,00,000). Both given as intraperitoneal instillation and incisional infiltration, provide adequate post-operative analgesia for similar duration of hours.
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