OBJECTIVEIs to compare the anaesthetic effects of intrathecal administration of hyperbaric Bupivacaine 10 mg with isobaric Ropivacaine 15 mg for elective caesarean delivery. METHOD100 parturients of ASA 1 and II posted for elective caesarean delivery were randomly divided into 2 groups of 50 each: Group A received intrathecal 0.5% Hyperbaric Bupivacaine 10 mg and Group B received intrathecal 0.75% isobaric Ropivacaine 15 mg. Time of onset and regression of sensory and motor blocks, haemodynamics, time of first complaint of pain, neonatal APGAR and side-effects were evaluated. RESULTSRopivacaine group has significantly slower onset of sensory analgesia at T6 (4.45±0.03 in Ropivacaine group as against 2.38±0.36 in Bupivacaine group, p <0.05), slower onset of Grade 3 motor block (6.46±2.48 in Ropivacaine group, 3.06±0.9 in Bupivacaine group p <0.05) and shorter duration of motor block (102.50±11.09 in Ropivacaine group as against 120.30±11.10 in Bupivacaine group p <0.05). Faster regression of the block to L1 and S2 was noticed in Ropivacaine group. (Regression to L1 122.6±20.5 in Ropivacaine and 144.10±28.19 in Bupivacaine group, p <0.05; Complete sensory regression to S1 150.0±14.8 in Ropivacaine and 169.6±20.4 in Bupivacaine group; p <0.05). Time to first complaint of pain was comparable in both the groups (168.9±26.0 in Ropivacaine and 170.2±25.5 in Bupivacaine group p >0.05). There was no difference in the haemodynamics and neonatal APGAR. Neither of the groups had any significant intraoperative or postoperative complications. CONCLUSIONIntrathecal Isobaric Ropivacaine 15 mg provides effective spinal anaesthesia for caesarean delivery. It has slower onset, shorter motor block, early sensory regression and similar postoperative analgesia and APGAR scores as compared to 10 mg of 0.5% hyperbaric bupivacaine. The shorter duration of motor block can facilitate early ambulation and makes Ropivacaine a good alternative for elective caesarean deliveries. KEYWORDSRopivacaine, Bupivacaine, Anaesthesia, Caesarean Deliveries. HOW TO CITE THIS ARTICLE:Konda RRM, Anpuram LN, Chakravarthy K. A study of hyperbaric bupivacaine versus isobaric ropivacaine for elective caesarean deliveries.

Lymphangiomas are commonly located in head and neck. They are congenital benign haemartomas of the lymphatic system. The most common location of intra oral lymphangiomas is the dorsum of the tongue. The lymphangiomas are amicable to surgical excision. Large oral lymphangiomas can decrease the already small mouth opening in the neonates and cause difficulty in mask ventilation, laryngoscopy and intubation. The postoperative challenges include laryngospasm and airway obstruction compounded by the large tongue and the airway odema caused by the surgical manipulations. Providing a safe anesthesia in such challenging cases necessitate awareness of the anesthetic complications and necessary steps to prevent them. In this case report we present a case of large oral lymphangioma in a newborn and discuss the peri operative and anesthetic management.