To compare the anaesthetic effectiveness and safety of ropivacaine 0.75% with bupivacaine 0.5% for spinal anaesthesia in patients having lower limb orthopedic surgery

Abstract

Background: Spinal anaesthesia, also known as subarachnoid block, is a fundamental method in the field of contemporary anesthesiology. Spinal anaesthesia is a very safe anaesthetic treatment because it provides deep pain relief, muscular relaxation, and causes fewer systemic and metabolic disruptions.
Aims and objectives: To compare the anaesthetic effectiveness and safety of Ropivacaine 0.75% with Bupivacaine 0.5% for spinal anaesthesia in patients having lower limb orthopaedic surgery.
Materials and methods: A prospective, randomised, double-blinded study was undertaken on 100 adult patients, aged between 18 and 62 years, who were having elective lower limb orthopaedic surgery under spinal anaesthesia. The patients were randomly separated into two equal groups (n = 50) using the odd and even technique. One group was given Ropivacaine (group R), while the other group was assigned Bupivacaine (group B).
Results: In group R, the average length of operation was 102.11±4.15 minutes, whereas in group B it was 105.29±5.22 minutes (P<0.05). There was no statistically significant difference seen in any of the groups. In group R (Ropivacaine), the average time for the sensory block to start at the T10 level was 2.77±0.36 minutes, whereas in group B (Bupivacaine), it was 3.21±0.39 minutes. The difference between the two groups was statistically significant with a p-value of 0.007. In group R, the time taken to reach the highest degree of sensory block was 8.09±0.77, whereas in group B it was 8.55±0.88. The value of P is 0.23. The average duration of sensory block was shorter in the Ropivacaine group (123.25±5.85 min) compared to the bupivacaine group (179.85±6.88 min; P = 0.001). The highest level of sensory block achieved with Ropivacaine was T5, and with Bupivacaine, it was T6 (Table 2). The average time it took for a motor block to occur was 4.52±0.56 minutes in group R and 4.89±0.63 minutes in group B. The difference between the two groups was not statistically significant (P = 0.07). The duration of motor block recovery in the bupivacaine group was 209.58±5.59 minutes, whereas in the Ropivacaine group it was 151.29±4.82 minutes (P = 0.001). Both groups of patients maintained intraoperative stability in terms of heart rate and mean blood pressure.
Conclusion: A hyperbaric solution of Ropivacaine (0.75%) can be utilised to achieve consistent spinal anaesthesia that is equivalent in quality to hyperbaric Bupivacaine (0.5%), but with a shorter duration of sensory and motor block.