A comparision between block characteristics of intrathecal hyperbaric bupivacaine versus hyperbaric levobupivacaine in patients undergoing infraumbilical surgeries a randomized clinical trial

Intrathecal anaesthesia is a type of neuraxial anaesthesia in which reversible blocking of nerve stimulus transmission is done by injecting local anaesthetics agents into subarachnoid space. It has advantages in cases where the airway approach is difficult as well as over the depressive effects on different systems by the agents used in general anaesthesia, also it is comparatively easy and safe technique. It has become popular technique for various infraumbilical surgeries like caesarean section, hernia operation, perineal surgeries, lower limb surgeries, lumber spine surgeries, urological surgeries etc.This study will be a Randomized controlled double blinded study to compare the block characteristics of hyperbaric bupivacaine and hyperbaric levobupivacaine in infraumbilical surgeries under spinal anaesthesia. A total number of 130 patients aged 18-60 years of male and female gender, ASA physical status I and II who will be undergoing infraumbilical surgeries surgeries shall be enrolled in the study. The patients will be divided into two groups of 65 each. The study drug will be prepared in a 5ml syringe by an anaesthesiologist not directly involved in the study to keep the study double blinded. Group B will receive 3 ml 0.5% hyperbaric bupivacaine, Group L will receive 3ml 0.5% hyperbaric levo bupivacaine. The operating room temperature will be maintained at an ambient temperature of around 24oC to 26oC. Vitals parameters like temperature, blood pressure, heart rate, SpO2 will be recorded preoperatively and intraoperatively. Time of onset of motor and sensory block ,its duration and time of regression will be recorded along with hemodynamic parameters and side effects.In case bradycardia will be defined as heart rate less than 50 beats per min and will be treated with 0.6mg Atropin IV whereas hypotension will be defined as decrease in systolic blood pressure more than 30% from the baseline and is treated with IV bolus of ringer lactate solution @15ml/kg over 15 mins and if not responded then IV inj Mephentermine 6mg IV should be injected. Fluids will be administered to replace intraoperative losses. The data collected will be analysed and interpreted by appropriate statistical method. Quantitative data will be analysed using Students t test and qualititative data will be analysed using Chi square test. P value <0.05 will be taken as significant.