A "COMPARATIVE STUDY BETWEEN BUPIVACAINE 0.5% AND ROPIVACAINE 0.75% IN EPIDURAL ANALGESIA IN PATIENTS UNDERGOING ELECTIVE LOWER ABDOMINAL AND LOWER LIMB SURGERIES"

BACKGROUND: Regional anaesthesia is noted for its simplicity, safety and effectiveness. Though spinal anaesthesia provides an efficient block it has some limitations. Epidural anaesthesia is one of regional techniques for lower abdominal and lower limb surgeries. Bupivacaine is the drug of choice for providing effective epidural analgesia. Ropivacaine is new long acting local anaesthetic with similar chemical structure but with less cardio toxicity and CNS toxicity. We did a Prospective Randomised control study to compare between two groups- 20ml of 0.75% Ropivacaine (Isobaric) and 20ml 0.5% Bupivacaine (Isobaric) for epidural anaesthesia in lower abdominal and lower limb surgeries in adults aged 18 to 60 years. AIM: To compare in two groups-20 ml of 0.75% Ropivacaine (Isobaric) and 20 ml 0.5% Bupivacaine (isobaric) for epidural anaesthesia in lower abdominal and lower limb surgeries in adults DESIGN: A Prospective randomized control study. METHODS: The study population was randomly divided into 2 groups with 30 patients in each group. Study group R-received 20ml of 0.75% Ropivacaine (Isobaric) by epidural route Study group B-received 20ml of 0.5% Bupivacaine (isobaric) by epidural route and compared 1. Onset of sensory and motor block, 2. Highest level of sensory block, 3. Degree of motor blockade (Using Modified Bromage scale) 4. Duration of motor blockade. 5. Duration of sensory analgesia. 6. Haemodynamic changes heart rate, blood pressure, respiratory rate. 7. Side effects if any. RESULTS: 0.75% Ropivacaine has a shorter duration of motor block when compared with 0.5% Bupivacaine. The onset of sensory and motor blocks, highest level of sensory block, degree of motor block and duration of sensory analgesia are similar to that of Bupivacaine. The haemodynamic changes and side effect profile of Ropivacaine is also not significantly different from that of Bupivacaine CONCLUSION: Based on the present clinical comparative study, we conclude that Ropivacaine can be used as a safe alternative to Bupivacaine for epidural anaesthesia in lower abdominal and lower limb surgeries. The shorter duration of motor block with Ropivacaine suggest that it could be effectively used for early mobilization of patients in the post-operative period.