A comparative evaluation of hyperbaric ropivacaine versus hyperbaric bupivacaine for elective surgery under spinal anesthesia

Abstract

Background:Recently introduced ropivacaine is 40% less potent than bupivacaine. Ropivacaine made hyperbaric by the addition of dextrose is known to provide reliable spinal anesthesia (SA). This study was designed to compare the clinical efficacy of equal doses of hyperbaric 0.5% ropivacaine with 0.5% bupivacaine for SA.Materials and Methods:Eighty American Society of Anesthesiologists grade I-II patients undergoing elective infraumbilical surgeries under SA were recruited and randomized to receive 3ml of hyperbaric ropivacaine 5mg/ml containing dextrose 83 mg/ml (by the addition of desired dose of 25% dextrose) in Group R or 3ml of hyperbaric bupivacaine 5mg/ml containing dextrose 80 mg/ml in Group B. Monitoring of vitals and observation for the block parameters were carried out. The data were presented as mean with a standard deviation and frequency with percentage. Statistical analysis was performed using InStat computer software with appropriate tests and P < 0.05 was considered to be significant.Results:Ropivacaine produced a slower onset of sensory block (ropivacaine 4.5 min; bupivacaine 3.2 min; P < 0.05) and the mean total duration of sensory block was significantly lesser (ropivacaine155 min; bupivacaine 190.5 min; P < 0.05). Patients in the ropivacaine Group R had significantly more rapid recovery from the motor blockade (ropivacaine120 min; bupivacaine 190 min; P < 0.05) and passed urine sooner than the patients in bupivacaine Group B (ropivacaine 257 min; bupivacaine 358 min; P < 0.05).Conclusion:Ropivacaine 15 mg in dextrose 8.3% provides reliable SA of shorter duration than bupivacaine 15 mg in 8% dextrose.

Comparison of Intrathecal 0.5% hyperbaric bupivacaine with 0.5% hyperbaric ropivacaine in lower limb and lower abdominal surgery

“…A similar finding was reported by Kulkarni et al. [17] and Whiteside et al. [18] The hemodynamic parameters were found to be comparable between the groups.…”

Intrathecal ropivacaine vs bupivacaine in endoscopic urological surgeries: a double blind randomized controlled trial

“…(157-234 min). 12,5,9,10 In our study hypotension was seen in most patients (41.7%) in group 1 compared to 18.6% in group 2. In another study bupivacaine group had 42.5% hypotension than in ropivacaine group 25%.…”

“…13 This was also proven by many studies. 5,9,14 and easily managed by mephenteramine bolus. Haemodynamic parameters such as heart rate, systolic blood pressure was similar in both groups.…”

“…Sample size was calculated by assuming the mean duration of sensory block in the ropivacaine group as 155 minutes and in bupivacaine group as 190 minutes, with respective standard deviations of 80 and 60, as per previous study by Kulkarni KR et al 5 The other parameters considered for sample size calculation were 80% power of study and 5% alpha error. Based on the above parameters the required sample size was 66 in each group, to account for a non-participant rate of about 10%, it was decided to include 71 subjects in each group.…”

Assessment of Plain and Hyperbaric Solutions of Ropivacaine in Patients Receiving Spinal Anaesthesia for Elective Surgeries: A Comparative Study

“…From the results, they concluded that shorter duration of spinal anaesthesia is provided by ropivacaine. 12 Chung et al evaluated the effectiveness and safety of hyperbaric ropivacaine and hyperbaric bupivacaine in providing spinal anaesthesia in patients undergoing elective caesarean delivery. They analyzed 60 patients undergoing elective caesarean surgeries and divided randomly into two study groups.…”