ABSTRACT
Introduction: Hypotension during spinal anaesthesia remained one of the most common complications since decades. Various factors such as posture, fluid status, and characteristics of local anaesthetic affect the overall incidence of hypotension in a parturient. This study was conducted to compare the incidence of spinal induced hypotension with 0.75% isobaric ropivacaine-fentanyl and 0.5% hyperbaric bupivacaine-fentanyl combination. Methods: 80 ASA I & II parturient were randomly divided into two groups to receive either 10 mg hyperbaric bupivacaine(0.5%)+ 25 μg fentanyl(BF) or 15 mg isobaric ropivacaine(0.75%)+ 25 μg fentanyl(RF).The sensory and motor block characteristics, haemodynamic parameters as well as any adverse effects were recorded. Results: Sensory block onset time was 4.5±1.2 min in BF v/s 6.6±1.8 min in RF group. Time to achieve maximum cephalad spread was 8.9±1.5 min in BF v/s 12.6±2.2 min in RF. Onset of motor block was significantly faster in group BF (2.6±1.3 min in BF v/s 5.1±1.3 min in RF). Time to first analgesic requirement was 243.8±20.1 min in BF v/s 236.3±12.4 min in RF. Haemodynamic parameters were more stable in RF. Conclusion: Intrathecal isobaric Ropivacaine-fentanyl combination is a suitable option for caesarean section as it shows less incidence of hypotension with adequate analgesia.
ABSTRACT
Background: The study was conducted to compare the quality and duration of block by addition of either clonidine or Butorphanol as an adjuvant/additive to epidural bupivacaine in orthopaedic surgical patients. Methods: 75 patients of either sex of ASA status I &II, between 20-60 years of age undergoing orthopaedic surgery were selected for the study. Patients were randomly divided into three groups of 25 each. Group I received 0.5% Bupivacaine (15ml) with 50 μg Clonidine in (1ml), Group II patients, received 0.5%Bupivacaine (15ml) with 1 mg Butorphanol (1ml) and Group III patients received 0.5% Bupivacaine (15ml) with Normal Saline (1ml). The hemodynamic parameters as well as quality of block including onset, completion and regression of motor block were observed. Parametric data were compared using analysis of variance (ANOVA). Inter group comparison was done using unpaired t-test, and chi square test. Results were expressed as mean ± SD and p< 0.05 was considered statistically significant. Result: The demographic profile was comparable among the three groups. Onset of analgesia was significantly early in butorphanol (9.08±2.58 min) group, followed by clonidine (10.6±2.5min) and control group. Duration of analgesia was longest in butorphanol group, followed by clonidine and control group. Height of sensory block achieved was comparable in the three groups (p>.05). Four hour postoperative pain score was significantly lower in butorphanol group as compared to clonidine and control group<0.05.Conclusion: The quality as well as block duration can be enhanced safely by addition of butorphanol as an additive to bupivacaine; butorphanol having an edge over clonidine for the same.