COMPARATIVE ANALYSIS OF ANAESTHETIC CHARACTERSTICS AND SAFETY OF INTRATHECAL 0.75% HYPERBARIC ROPIVACAINE AND 0.5% HYPERBARIC BUPIVACAINE IN PATIENTS UNDERGOING INFRA-UMBILICAL SURGERIES - A RANDOMIZED DOUBLE - BLIND STUDY

Regional anaesthesia plays a pivotal role in providing effective pain relief and facilitating early recovery in patients undergoing infra-umbilical surgeries.

Spinal Anaesthesia (Intrathecal Anaesthesia) is a widely employed form of central neuraxial blockade.It involves the injection of a local anaesthetic into the cerebrospinal fluid (CSF) present in the subarachnoid space, typically between the L3-L4 or L4-L5 intervertebral space. This leads to reversible blockade of nerve conduction, resulting in loss of sensation and muscle relaxation below the level of the block.

Spinal anaesthesia is often favoured over general anaesthesia for surgical procedures involving the lower abdomen and lower limbs, owing to its numerous advantages such as the simplicity of equipment, cost-effectiveness, provision of profound analgesia, satisfactory muscle relaxation, reduced intra operative blood loss and minimal metabolic disturbances.

Ropivacaine and Bupivacaine are two long-acting local anaesthetics widely used in spinal anaesthesia. Both agents are effective for producing adequate sensory and motor block.

Bupivcaine, introduced in 1956, is an amino acid local anaesthetic comprising a racemic mixture of S- and R-enantiomers. It has become a preferred agent for spinal anaesthesia due to its ability to achieve effective sensory and motor blockade.

Bupivacaine has been associated with several side effects including motor weakness, urinary retention and toxicity affecting the cardiovascular and central nervous system.

Ropivacaine is a newer long-acting amide local anaesthetic and the monohydrate of the hydrochloride salt of 1-propyl-2’,6’-pipecoloxylidide. It is the first clinically used pure      S(-) enantiomeric local anaesthetic.  It came into market in 1996. This contributes to its lower risk of cardiovascular and central nervous system toxicity as compared to bupivacaine.

Although numerous studies have evaluated the use of ropivacaine for local infiltration, epidural and peripheral nerve blocks. Clinical data regarding its characteristics following intrathecal administration remain limited.