Key result
Intrathecal 0.5% levobupivacaine with fentanyl produced a faster onset and longer duration of motor block compared to 0.5% ropivacaine with fentanyl in lower abdominal surgeries (P<0.0001).
Why the study?
With increasing trends toward ambulatory day care surgery, rapid discharge, and reduced hospital stay, comparing anesthetic regimens for lower abdominal surgeries is needed.
Does intrathecal 0.5% levobupivacaine with fentanyl improve onset time and duration of motor block compared to 0.5% ropivacaine with fentanyl in patients undergoing lower abdominal surgeries?
Observational (n=60)
No
Does intrathecal 0.5% levobupivacaine with fentanyl improve onset time and duration of motor block compared to 0.5% ropivacaine with fentanyl in patients undergoing lower abdominal surgeries?
p-value: p=<0.0001
Intrathecal levobupivacaine with fentanyl provides faster onset and longer duration of motor block compared to ropivacaine with fentanyl for lower abdominal surgeries.
INTRODUCTION:The recent trend in health care centres everywhere is to provide cost effective care to the patients. There is an increasing trend towards ambulatory day care surgery and rapid discharge of the patients. The operation of inguinal hernia or incisional hernia and even simple ligation surgeries are done without much complexities nowadays and can be completed in 60-90min without much intra or postoperative complications. Hence these have become an ideal procedure for outpatient setting and thereby reducing length of hospital stay. AIMS AND OBJECTIVE:A comparative study of efcacy, potency and recovery of intrathecal 0.5% ropivacaine with fentanyl and 0.5% levobupivacaine with fentanyl in lower abdominal surgeries in patients of 18-60years of age. MATERIALS AND METHOD: This is a prospective, comparative, observational study was conducted on 60 patients undergoing various lower abdominal surgeries under subarachnoid block (SAB) at Nil Ratan Sircar Medical College and Hospital, Kolkata, West Bengal. This study was conducted over a period of 24-month. Approval of the Institutional Ethics Committee was taken. Awritten informed consent in the local language was taken from every patient. RESULT AND ANALYSIS: In RF 5 patients (17%) had onset at 3min, 17patients (57%) at 6min, 7 patients (23%) at 9min, 1 patient (3%) at 12min. In LBF 8 patients had onset at 0 min, 22 patients had onset at 3min. p value is less than 0.0001 which is statistically signicant. In RF, 23 patients (77%) had duration of motor block for 150min and 7 patients (23%) had for 180min. In LBF, 26 patients (87%) had duration of motor block for 210 min and 4 patients (13%) had for 180min. The p value is less than 0.0001, which is statistically signicant. SUMMARYAND CONCLUSION: This study was to compare potency, efcacy and recovery between the two groups of drugs. A potency of a drug is a measure of drug activity expressed in terms of the amount required to produce an effect of given intensity. Here both the drugs in comparison was given in equal concentration and found that levobupivacaine produced higher effect, reached Bromage 3 in lesser time than ropivacaine. So levobupivacaine was more potent drug. Efcacy is the ability to get a job done satisfactorily
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Mitra et al. (2021) conducted an observational in Lower abdominal surgeries (n=60). 0.5% levobupivacaine with fentanyl vs. 0.5% ropivacaine with fentanyl was evaluated on Onset and duration of motor block (p=<0.0001). Intrathecal 0.5% levobupivacaine with fentanyl produced a faster onset and longer duration of motor block compared to 0.5% ropivacaine with fentanyl in lower abdominal surgeries (P<0.0001).
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