Effects of intrathecal hyperbaric ropivacaine versus hyperbaric bupivacaine for lower limb orthopedic surgery

Background: Regional anesthesia, increasingly used for infraumbilical surgery, has advantages of decreased stress response to surgery, nausea, vomiting, and cardio-respiratory depression with improved postoperative analgesia, in comparison to general anesthesia. Intrathecal isobaric ropivacaine (RP) had been found, in various clinical studies, to be shorter acting in comparison to bupivacaine (BP). Our present study was, hence, aimed to compare the anesthetic and analgesic efficacy of intrathecal hyperbaric RP relative to hyperbaric BP in lower limb orthopedic surgery. Materials and Methods: A total of 100 patients aged ranges between 18 and 60 years of either sex, ASAPS 1 and 2, undergoing elective lower limb orthopedic surgeries were divided into two groups, RP group and BP group receiving intrathecal 0.75% RP 3 ml and glucose 50%, 0.5 ml and 0.5% hyperbaric BP 3 ml and 0.9% normal saline 0.5 ml, respectively. The efficacy in terms of onset and duration of anesthesia and analgesia were assessed along with the heart rate, blood pressure at regular intervals throughout the perioperative period. Result: The two study groups were comparable in terms of demography and duration of surgery. Patients in group RP experienced significantly late onset and shorter duration of sensory and motor block in comparison to patients in group BP. There were clinically insignificant differences in perioperative hemodynamics and side-effects noted in each group. Hence, it was observed in this study that equipotent dose of hyperbaric RP had shorter duration of analgesia and anesthesia than with equipotent dose of hyperbaric BP.