A Prospective Randomised Study to Compare the Efficacy of Intrathecal Bupivacaine 0.5% and Intrathecal 0.75% Ropivacaine in Lower Abdominal and Lower Limb Surgeries

This prospective randomised studywill be conducted in Dr D.Y.Patil hospital & medical college , Navi Mumbai,Department of Anesthesiology, after institutional ethics committee clearance.

The study population will berandomly divided into two groups.

Group 1(SR) ,n=45: will receive3.2ml of 0.75% Ropivacaine heavy

Group 2(SB), n=45: will receive3.2ml of 0.5% Bupivacaine heavy

The patients will be subjected to apreoperative anesthesia check.

Written informed consent willbe obtained before starting any study procedures.

Proper fasting guidelines will beexplained a day prior to surgery.

On the day of surgery Afterchecking the patient’s written informed consent and adequate NBM status, thepatient will be wheeled in operation theatre. The baseline preoperativeparameters would be recorded before inducing anaesthesia. ,intravenous cannula20gauge(G) or 18 gauge will be inserted on the upper extremity.Intravenous  fluid ,ringer lactate will be started.

Routine  IntraoperativeMonitoring such as

pulse oximeter (SpO2),

electrocardiogram (ECG),

non -invasive blood pressure(NIBP) will be done

Hypotension (20% decrease in MAP),if any, will be treated with intermittent boluses of intravenous ephedrine (6mg)

Bradycardia (HR < 50/ minute)will be treated with intravenous atropine 0.6 milligram (mg) or Glycopyrrolate0.2mg.

Patients will receive spinalanesthesia in sitting position, under aseptic precautions with 25G, Quincketip, spinal needle, by a qualified anesthesiologist.

Group 1 will receive intrathecal3.2 ml of 0.75% Ropivacaine and group 2 will receive intrathecal 3.2ml of 0.5% Bupivacaine.

Patients will be positioned supineimmediately.

Sensory block and level will bechecked using a 25 G hypodermic needle.

Heart rate (HR), systolic (SBP) , diastolic(DBP)and mean arterial pressure (MAP) will be measured every 2 mins from theonset of block for the first 20 mins, thereafter every 10 minutes till the endof the procedure.

Onset of motor blockwill be defined as time frominjection till motor paralysis equivalent to Bromage score 3.

Duration of sensory blockwill be defined as thetime between onset of sensory block to return of touch sensation at L1.

Duration of motor blockwill be defined as thetime between onset of motor block to complete return of motor power (Bromage 0).

Duration of analgesia will be defined as the timefrom commencement of block to time when patient first demand rescue analgesia(VAS > 4).

Pain assessment will be done by using visual analogue scale