Background: Orthopaedic surgeries of lower limb are well suited for central neuraxial blockade. While the surgeries are done under spinal anesthesia, demand for post operative pain relief and need to reduce the use of systemic analgesics requires epidural analgesia in the post-operative period.
Objective: To evaluate and compare the duration of analgesia of 0.375% Ropivacaine and 0.25% Levobupivacaine given by epidural routes in lower limb orthopaedic surgeries in 24 hrs post operative period.
Material and Methods: In this prospective, randomized, double blinded clinical study, 60 adult patients of ASA I-II of both sexes were randomized into 2 groups(n=30). Patients received 7ml of 0.375% Ropivacaine in group R and 7ml of 0.25% Levobupivacaine in group L through epidural catheter.
Results: There was no significant difference between two groups with respect to demographic profile and ASA physical status. The mean duration (minutes) of analgesia after each epidural topup was significantly longer in group L (303.5\(\pm\)21.8) compared to group R (273.2\(\pm\)23.42) with p value 0.001. Total number of epidural topups were 5 for both the groups, rescue analgesics were needed in only 2 patients in each group. Quality of motor block was predominantly grade 0 of modified bromage scale in more than 80% patients in both the groups. Haemodynamic stability was well maintained and no adverse effects encountered in both the groups.
Conclusion: Epidural 0.25% Levobupivacaine and 0.375% Ropivacaine in their equipotent doses provided adequate post operative analgesia for lower limb orthopaedic surgeries. Levobupivacaine provided prolonged duration of analgesia compared to ropivacaine. But the total number of epidural topups, need for rescue analgesics and quality of motor block were similar for both the study drugs without any haemodynamic variations and adverse effects.
