Comparison Of Intrathecal Hyperbaric Bupivacaine with Fentanyl Versus Hyperbaric Ropivacaine with fentanyl for perineal surgeries under Subarachnoid block : A Randomised controlled study

Subarachnoid block is commonly practiced worldwide as a standard of care for perineal, lower abdominal and lower limb surgeries. It has been proven that combination of adjuvants to local anaesthetic prolong duration of analgesia postoperatively.Ropivacaine has high pka, low lipid solubility[3].It is found to block sensory nerves to a greater degree than motor nerves .Ropivacaine and Bupivacaine have similar local anesthetic properties and chemical structure[1][4]. Ropivacaine is expected to be a suitable drug for day care surgeries because of less motor block with great sensory motor dissociation and could be associated with early post-operative mobilization.

The concept of day-care or ambulatory surgery has been well established in developed countries though it is still in its infancy in developing countries such as India. There is an immense opportunity for expansion in day-care surgery in India with it’s huge population of 1.2 billion and expanding private sector .

In India, there is lack of studies with proper documentation regarding day-care anaesthesia . 11%–23% of the surgeries in India performed in hospital settings are considered to be on outpatient basis based on available data from unpublished source.

The study aims to compare relatively novel drug ropivacaine with bupivacaine in it’s effectiveness in terms of duration of anaesthesia , intraoperative quality of block and post operative recovery in perineal surgeries , a ususal form of ambulatory surgery. The identification of a suitable drug for ambulatory surgeries would help in popularizing the method of surgery and would cut down cost ,easy return to work , lack of dependency on availability of hospital beds, reduced nosocomial infection rates for patients.