Efficacy of Intrathecal 0.5% Hyperbaric Ropivacaine for Day Care Gynaecological Procedures: An Interventional Study from a Tertiary Care Centre, Telangana, India

Abstract

Introduction: Although various beneficial effects of intrathecal local anaesthetics have been proven, their use is limited by dosedependent adverse effects. Ropivacaine, a local anaesthetic, has been demonstrated to provide safe and reliable spinal anaesthesia of the required duration, with a relatively shorter duration of motor block that encourages earlier mobilisation in patients. Aim: To examine the efficacy of a hyperbaric solution of ropivacaine for spinal anaesthesia in minor gynaecological surgeries in a day care setting. Materials and Methods: This was an interventional study involving 60 subjects undergoing day care gynaecological surgery. The subjects were between 18 and 65 years old. Basic vital signs were recorded. All patients were preloaded with 15 mL/kg of Ringer’s lactate 15 minutes before surgery. Lumbar puncture was performed at the L3-L4 space. Patients received 3 mL of 0.5% hyperbaric ropivacaine (2 mL of 0.75% ropivacaine combined with 1 mL of 5% dextrose). Variations in vital signs were recorded during all phases of surgery. The onset and total duration of sensory and motor blockade, variations in vital signs at preoperative and postoperative phases, side-effects, time for ambulation and time for rescue analgesics were assessed. The values were expressed as means, frequencies and percentages. IBM Statistical Package for the Social Sciences (SPSS) Statistics version 29.0 was used to analyse all the data. Results: The onset of sensory blockade to reach T10 occurred in 214.90 seconds, while the onset of motor blockade occurred in 205.13 seconds. The sensory blockade persisted for 366.17 minutes, whereas the motor blockade continued for 153.57 minutes. Significant changes were observed from the preoperative period to 60 minutes in the mean values of Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), and Mean Arterial Pressure (MAP) (p-value<0.05), while there was no change in Heart Rate (HR) and Oxygen Saturation (SpO2 ). Conclusion: Day care surgery can be performed effectively with spinal anaesthesia using intrathecal ropivacaine. The more reliable and effective anaesthesia provided by intrathecal ropivacaine improves the expediency for anaesthetists.

Keywords

• : ambulation
• day care surgeries
• motor block
• sensory block
• spinal anaesthesia