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The Efficacy and Safety of Spinal Anesthesia With Hyperbaric Ropivacaine 0.75% and Bupivacaine 0.5% in Patients Undergoing Infra-Umbilical Surgeries: A Randomized, Double-Blind Study.
Kalbande, Jitendra V; Kukanti, Chandini; Karim, Habib Md R; Sandeep, Gade; Dey, Samarjit.
Afiliación
  • Kalbande JV; Anaesthesiology and Critical Care, All India Institute of Medical Sciences, Raipur, Chhattisgarh, IND.
  • Kukanti C; Neuroanaesthesiology and Critical Care, All India Institute of Medical Sciences, New Delhi, New Delhi, IND.
  • Karim HMR; Anaesthesiology, Critical Care, and Pain Medicine, All India Institute of Medical Sciences, Deoghar, Jharkhand, IND.
  • Sandeep G; Anaesthesiology and Critical Care, All India Institute of Medical Sciences, Raipur, Chhattisgarh, IND.
  • Dey S; Anaesthesiology, All India Institute of Medical Sciences, Mangalagiri, Guntur, IND.
Cureus ; 16(3): e57005, 2024 Mar.
Article en En | MEDLINE | ID: mdl-38681261
ABSTRACT

BACKGROUND:

Spinal anesthesia utilizing hyperbaric 0.75% ropivacaine has been gaining clinical acceptance recently. It is a pure S-enantiomer of bupivacaine, which is expected to have a better clinical profile, but the studies for the same are yet limited. We aimed to compare the efficacy and safety of these two drugs.

METHODS:

Sixty patients, aged 18 to 60 years of either sex, classified as American Society of Anesthesiologists class I and II, who were undergoing elective infra-umbilical surgery, were randomly assigned to receive either 3 mL of 0.5% bupivacaine heavy or 3 mL of 0.75% ropivacaine heavy intrathecally. Efficacy parameters, including the onset and duration of sensory and motor block, time to rescue analgesia, hemodynamics, and safety in terms of complications, were recorded. We compared the data for statistical significance, considering a p-value of less than 0.05 as significant.

RESULTS:

Ropivacaine exhibited a slower onset for both sensory (153.90 ± 6.53 versus 92.46 ± 12.16 seconds; p < 0.001) and motor blockades (301 ± 6.62 versus 239.96 ± 6.27 seconds; p < 0.001). Two-segment sensory and motor blockade regression were faster with ropivacaine compared to bupivacaine (p < 0.001). However, the mean duration of sensory blockade for ropivacaine compared to that for bupivacaine (219.29 ± 15.14 versus 227.31 ± 17.20 minutes) and the requirement for rescue analgesia were not statistically different (p > 0.05). Ropivacaine also caused fewer side effects on a percentage scale.

CONCLUSION:

In patients undergoing infra-umbilical surgery, hyperbaric ropivacaine at an equipotent dose (0.75%) proved to be a comparable and safer alternative to hyperbaric bupivacaine (0.5%). Furthermore, it had better motor-recovery profiles.
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Texto completo: 1 Colección: 01-internacional Idioma: En Revista: Cureus Año: 2024 Tipo del documento: Article

Texto completo: 1 Colección: 01-internacional Idioma: En Revista: Cureus Año: 2024 Tipo del documento: Article