Comparative Evaluation of Haemodynamic Changes and Complications Associated With Two Different Doses of Ropivacaine Hydrochloride (0.75% and 0.5%) in Spinal Anaesthesia in Lower Limb Orthopaedic Surgeries

Abstract

BACKGROUNDThe introduction of safe drugs enhanced the popularity of spinal anaesthesia. Lofgren and Lundqvist introduced the most commonly used drug, Lignocaine. One of the disadvantages of Lignocaine was the association with transient neurological symptoms, which presents as low backache and lower extremity dysesthesia. Bupivacaine was introduced by Ekenstam in 1957. It is a well-established long-acting local anaesthetic used for spinal anaesthesia. It has been used frequently in spinal anaesthesia with a very little incidence of transient neurological symptoms. But it is associated with cardiovascular and central nervous system toxicity when used in high concentration or when accidentally administered intravascularly. Ropivacaine was introduced into clinical practice in 1996. It was initially used in epidural anaesthesia in lower extremity surgery, where it was compared with bupivacaine where they concluded that ropivacaine produced similar sensory and motor blockade with less cardiotoxicity. In a study, different concentrations of intrathecal ropivacaine 0.5% and 0.75% were compared for vascular surgery, which concluded that 15 mg of plain ropivacaine 0.75% is effective and safe and gives complete spinal anaesthesia in high risk patients without side effects and cardiovascular modifications.The aim of this study was to compare and evaluate the haemodynamic changes and side effects associated with equal volumes of two different doses of ropivacaine hydrochloride (0.75% and 0.5%) used in spinal anaesthesia in lower limb orthopaedic surgeries.