Comparison of anesthetic and analgesic effect of isobaric 0.5% ropivacaine versus levobupivacaine with fentanyl as adjuvant in lower limb surgeries under spinal anesthesia- a randomized double-blind, interventional study

Abstract

Background: Spinal anesthesia is a widely used technique for lower abdomen and lower limb surgeries. We used opioids as an adjuvant to attain a dense block and increase the duration of surgery. The purpose of the study is to compare the anesthetic and analgesic effects of intrathecal isobaric 0.5% ropivacaine-fentanyl versus isobaric 0.5% levobupivacaine-fentanyl in patients undergoing lower limb surgeries. Material and methods: This prospective randomized double-blind interventional study was carried out in ASA I and II, aged 18 to 60 years. Injection Isobaric ropivacaine (0.5%) 2.5 ml with injection fentanyl 0.5 ml (25 μg) intrathecally in group A (n=30) and Inj. Isobaric levobupivacaine isobaric (0.5%) 2.5 ml with injection fentanyl 0.5 ml (25 μg) intrathecally in group B (n=30) was used. The sealed envelope method was used for group allocation. Results: Both groups' demographic and hemodynamic data were comparable. There was a faster onset of sensory and motor block in the levobupivacaine group than in the ropivacaine group with fentanyl, and the result was statistically significant. (P value 0.008). Sensory and motor block durations were shorter in the ropivacaine than in the levobupivacaine with the fentanyl group. There is a statistically significant difference between the two groups' time to first-dose rescue analgesia. Conclusion: We deduce in our study that using intrathecal 2.5 ml of 0.5% ropivacaine with 0.5ml fentanyl (25 micrograms) helps in early ambulation and can be used in day-care lower limb surgeries when compared with levobupivacaine.

Keywords

• levobupivacaine
• ropivacaine
• fentanyl
• spinal anesthesia