Comparison Of Epidural Bupivacaine 0.5% With Epidural Ropivacaine 0.75% For Lower Limb Orthopedic Procedures

Abstract

Epidural blockade is becoming one of the most useful and versatile procedures in modern anesthesiology. Bupivacaine is a long acting amide local anaesthetic which is widely used since many years. However, it is associated with a number of side effects like Central Nervous System (CNS) toxicity and cardiotoxicity. Ropivacaine is a newly introduced long acting amide local anaesthetic drug in India which has been developed as a possible alternative to Bupivacaine. It has a lower lipophilicity than bupivacaine and hence associated with a decreased potential for CNS and cardiotoxicity. AimsThe aim of the study was to compare the time of onset of sensory block and duration of sensory and motor blockade of epidural anaesthesia produced by bupivacaine 0.5% and ropivacaine 0.75% for lower limb surgery.Methods60 patients, aged between 18-60 years, ASA 1 and 2, undergoing various lower limb surgeries were randomly allocated to 2 groups of 30 each. Group A received 15ml of 0.75% ropivacaine and group B received 15 ml of 0.5% bupivacaine epidurally. The time for loss of pinprick at T10, intensity of motor block, duration of sensory and motor block and hemodynamic changes were assessed.Results1. The time of onset and duration of sensory block was comparable for both the drugs.2. Bupivacaine 0.5% produced more intensity and longer duration of motor block than ropivacaine 0.75%3. Both the drugs were comparable with respect to hemodynamic changes.ConclusionEpidural ropivacaine 0.75% can be safely used as a possible alternative to bupivacaine 0.5% in lower limb orthopedic procedures.