A Comparison of Intrathecal Isobaric Ropivacaine 0.5% and 0.75% for Orthopaedic Lower Limb Surgeries and Lower Abdominal Surgeries.

Background: Aim: This study was done to evaluate the onset, extent and duration of sensory and motor block and side effects of ropivacaine when used in spinal anaesthesia in lower limb orthopedic and lower abdominal surgery. Methods: A prospective randomized double blind study was conducted on 60 patients of ASA status I and II, posted for lower limb orthopaedic and lower abdominal surgery. All patients were randomly allocated into two groups of 30 each; group I received 3ml of isobaric ropivacaine 0.5%(15mg) and group II received 3ml of 0.75% (22.5mg)isobaric ropivacaine in subarachnoid block. The onset, extent, duration of sensory and motor block and side effects were recorded. Results: Onset of sensory block and highest level of sensory block achieved was comparable in both the groups. The duration of sensory block at T10 and total duration of sensory blockade was prolonged in-group II in comparison to group I, which was statistically significant. The onset time of motor block was comparable in both groups. Time to maximum degree of motor block was longer in group I (17.45±6.63min) compared to group II(11.04±4.26min) which was statistically significant. Total duration of motor block was longer in group II(152.60±23.02min) compared to group I( 112.62±13.72min)which was statistically significant. Conclusion: 0.75% ropivacaine when used in spinal subarachnoid block prolonged the sensory and motor block in comparison to 0.5% ropivacaine.

Comparative Study of Clonidine and Magnesium Sulfate Used as Adjuvant to Epidural Bupivacaine in Orthopedic Lower Limb Surgery.

Background: A lot of researches have been done to find an ideal adjuvant to bupivacaine in epidural anaesthesia that inhibits intra and post operative pain and prolongs the duration of anaesthesia without any side effects. Study regarding antinociceptive effect of magnesium in epidural route is very limited. Aim: This study was done to evaluate the onset, extent and duration of sensory and motor block and side effects of clonidine and magnesium sulfate when used as an adjuvant to bupivacaine in epidural anaesthesia in lower limb orthopedic surgery. Methods: A prospective randomized double blind study was conducted on 60 patients of American society of anaesthesiologists status I and II, posted for lower limb orthopedic surgery. All patients were randomly allocated into two groups of 30 each; group I was bupivacaine - clonidine group (BC) and group II was bupivacaine – magnesium sulfate group (BM). Group I (BC) patients received 16 ml of 0.5% bupivacaine and clonidine 2mcg/kg. Group II (BM) patients received 16 ml of 0.5% bupivacaine and magnesium sulfate (50 mg). The onset, extent, duration of sensory and motor blocks and side effects were recorded. Results: Magnesium sulfate had a visible edge over clonidine as it enabled an earlier onset of sensory block but duration of analgesia was more in clonidine group. Sedation scores were statistically significant with BC group in comparison to BM group. Both groups were haemodynamically stable in peri and post-operative period. Conclusion: Magnesium sulfate was a better alternative to clonidine as an adjuvant to bupivacaine in epidural anaesthesia in orthopedic lower limb surgeries for rapid onset of action but clonidine has prolonged duration of action.