“Comparison of clinical efficacy and tolerability of Epidural 0.5% Levobupivacaine with 0.75% Ropivacaine in patients undergoing elective lower abdominal surgery”

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Dr. Ashok Kumar Balasubramanian

Abstract

The aim of the study is to compare the efficacy and tolerability of 0.5% Levobupivacaine and 0.75% Ropivacaine, in patients undergoing lower abdominal surgery.56 patients, ASA grade 1 and 2, were randomised to receive an epidural injection of study drug  (17 ml 0.5% Levobupivacaine in group L and 17 ml of 0.75% Ropivacaine in group R. The objective of the study was to compare sensory, motor, haemodynamic and side effect profile of the 2 drugs. The mean time for onset of sensory block, maximum dermatome reached was faster and higher in R group. The time taken to attain maximum sensory level in two groups is similar. The Time for 2 segment regression and the duration for regression of sensory block to dermatomal level T10 were slower in group R. Total duration of analgesia in R group was 301.96, whereas in L group it was 319.09 min (p value 0.579). The time for complete reversal of sensory block was 345.54 in R group versus 418.93 min in L group (The p value <0.05).The onset of motor block, regression of motor block and duration of motor block were comparable in both the groups. The grade of motor block as per MBS score was significantly different in both groups. The time taken to attain the maximum motor blockade was 40.18 min in group R and 17.86 min in group L.(p value of 0.043). The mean duration of motor block in R group was146.25 ±48.58 min and in L group was 160.71 ±46.64 min. (p value >0.05). The MAP and HR were similar at different periods. Both study drugs produced effective epidural anaesthesia and were well tolerated in patients undergoing lower abdominal surgery.

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