Efficacy and Safety of the Combination of Ropivacaine, Bupivacaine and Fentanyl in Spinal Anesthesia

Abstract

Objective:The aim of this study is to compare clinical parameters observed in spinal anesthesia, using the combination of hyperbaric bupivacaine with isobaric ropivacaine and fentanyl (BRF), versus hyperbaric bupivacaine with fentanyl (BFS), in procedures scheduled for surgery under neuraxial block.Methods: This was a prospective, randomized, double blind. We included 28 patients scheduled for surgery, 14 per group, with a level of significance of 5% (= 0.05) and a statistical power of 80%, randomly distributed, without contraindications for the application of neuraxial block. ASA I-III, older than 18 years. Neuraxial block and local anesthetic solution were applied in the subarachnoid space. Block latency, vital signs, initial and final sensory level, initial and final motor level, hemodynamic changes, presence of pain, adverse reactions and patient comfort were evaluated.Results: A similar level of motor block was observed but a greater sensory block when RBF was administered. The total time of duration was almost double for the BRF group. In both groups hemodynamic stability was observed without vasoactive drug requirements. In the RBF group a decrease in blood pressure was observed 20 minutes after the application of the block, instead in the BFS group the decrease in blood pressure occurred in the first minutes. The duration of analgesia was similar for both groups. No statistically significant difference was found regarding the presentation of adverse effects in the first 24 hours after surgery. Conclusions:Using the combination of BRF, a potentiation synergy occurs, with the same efficacy and safety as BFS, but also with the advantage of a longer duration of motor and sensory block.