ABSTRACT
Background: Ropivacaine and levobupivacaine, introduced recently for clinical use claim benefits over bupivacaine in the form of differential blockade and reduced cardiac and CNS toxicity. This study was undertaken to compare the clinical efficacy of 0.75% Ropivacaine with 0.5% Levobupivacaine for epidural anaesthesia in patients undergoing lower abdominal surgeries.
Methods: This randomized clinical study was conducted on 90, ASA grade I and II patients of either gender, aged between 20 to 60 years who were allocated to receive either 15ml of 0.75% plain ropivacaine or 15 ml of 0.5% plain levobupivacaine epidurally for elective lower abdominal surgeries at KLES Dr. Prabhakar Kore Hospital. Statistical testing was conducted with the statistical package for the social science system version SPSS 17.0.
Results: The groups were statistically similar as regards demographic data and pre anaesthetic characteristics. The duration of motor blockade was shorter in group R (111.53 ± 16.70min) as compared to group L (118.53 ± 18.14 min;p=0.056). Ropivacaine produced lesser degree of motor blockade and provided a longer duration of postoperative analgesia than levobupivacaine (263.0 ± 22.77 vs 253.78 ± 24.43 minutes) although the difference remained statistically insignificant. Discussion: The study by Peduto et al, comparing epidural 0.5% levobupivacaine and 0.75% ropivacaine for lower limb surgery, found a duration of motor block which was lesser with ropivacaine than with levobupivacaine.
Conclusion: Both 0.75% ropivacaine and 0.5% levobupivacaine when administered epidurally for elective lower abdominal surgeries, provide adequate and comparable motor blockade. Ropivacaine results in a shorter duration of motor blockade and provides a longer duration of sensory blockade and post operative analgesia.
Keywords Ropivacaine; Levobupivacaine; Epidural anaesthesia.