Comparative study of intrathecal ropivacaine-fentanyl and bupivacaine-fentanyl for lower limb orthopaedic surgeries

Intrathecal bupivacaine results in a longer duration of complete anaesthetic block than ropivacaine. Fentanyl used as an adjuvant may improve the quality of spinal block of ropivacaine, while maintaining its advantage of early motor recovery. The aim of the study was to compare the efficacy and safety of intrathecal ropivacaine-fentanyl (RF) with bupivacaine-fentanyl (BF) for lower limb orthopaedic surgeries. In this Single Centered, Prospective, Randomized, Parallel group, Double-Blind study, sixty patients were randomly allocated to receive either intrathecal 15 mg of 0.5% ropivacaine with 25 mcg fentanyl (Group RF) or 15 mg of 0.5% bupivacaine with 25 mcg fentanyl (Group BF). The onset, duration, spread of sensory and motor block, hemodynamic parameters, and side effects were recorded. Data analysis was done using SPSS software and Sigma Stat 3.5 version (2012). The time to reach the highest sensory level, complete motor block, and two-segment sensory regression time were comparable between the two groups. The motor recovery to Bromage scale 1 was faster in Group RF. The hemodynamic stability was better in Group RF. However, the time duration of analgesia was prolonged in Group BF. Intrathecal RF provided satisfactory anesthesia with hemodynamic stability for lower limb orthopaedic surgeries. It provided a similar sensory but a shorter duration of motor block compared to BF, which is a desirable feature for early ambulation, voiding, and physiotherapy.