Trends in Clinical and Medical Sciences
Special issue: Indian Medical Research Views and Findings on Last 5 years (2023), pp. 169 – 177
ISSN: 2791-0814 (online) 2791-0806 (Print)
DOI: 10.30538/psrp-tmcs2023.si-imrv026
ISSN: 2791-0814 (online) 2791-0806 (Print)
DOI: 10.30538/psrp-tmcs2023.si-imrv026
A prospective, randomized, double-blinded clinical study of comparative evaluation of post operative analgesia with epidural ropivacaine 0.375% and epidural levobupivacaine 0.25% in lower limb orthopaedic surgeries
Harshitha MS\(^{1}\), Pallavi SR\(^{1}\) and Nagashree J Bharadwaj\(^{2,*}\)
\(^{1}\) Senior Resident, Department of Anesthesiology, Shimoga Institute of Medical Sciences, Shimoga, India.
\(^{2}\) Senior Resident, Department of Anesthesiology, Dr. B R Ambedkar Medical College and Hospital, Bangalore.
Correspondence should be addressed to Nagashree J Bharadwaj at nagashree.brj@gmail.com
Copyright © 2023 Harshitha MS, Pallavi SR and Nagashree J Bharadwaj. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Received: April 2, 2023 – Accepted: May 18, 2023 – Published: May 24, 2023
Abstract
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.
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.
Keywords:
Ropivacaine; Levobupivacaine; Lower limb orthopaedic surgery; Epidural; Post operative analgesia.