Comparison of the Effect of Epidural Levobupivacaine 0.5 Percentage 20 ML and Ropivacaine 0.75 Percentage, 20 ML in Lower LIMB Surgeries

Abstract

Introduction: Regional anaesthesia is noted for simplicity, safety and effectiveness. Anaesthesia having least onset time and which can be prolonged with least complications is a challenge to anaesthesiologist. Though spinal anaesthesia provides an efficient block, duration is constant and cannot be prolonged. Epidural anaesthesia is a technique for lower limb, pelvic surgeries where complications are less compared to spinal anaesthesia. There is no limitation for duration of surgery if a catheter is in place, a modality for pain relief. Motor block appears to regress considerably rapidly than sensory block. This makes it specially well suited for epidural administration.Materials and methods: The patient was placed in left lateral position with all aseptic precautions edipural space identified at L2-L3 interspace after local infiltration with 2 ml 2% lignocaine. Epidura space is identified using 18 G Touhy needle by loss of resistance technique. Epidural catheter passed into the epidural space through the needle in a cephalad direction until 3cm is in the space. After test dose i.e., 3 ml of 2% lignocaine with adrenaline 1:200000. 4 minutes later 20 ml of drug injected through catheter over 3 minutes. All patients were monitored for cardio respiratory problems, side effects if any and were given supplemental O2. The following parameters were observed and recorded.Results: On comparison it was found that in Group R there were 4 patients (13%) who had Grade 2 block and 26 patients (87%) who had Grade 3 block. In Group B, 3 patients (10%) had Grade 2 block and 27 patients (90%) had Grade 3 block. The percentage distribution of patients who had Grade 2 and Grade 3 was similar in both the groups. Haemodynamic effects i.e. BP, SPO2 & PR at various intervals. There is no significant changes in PR, SBP and DBP.Conclusion: Epidural anaesthesia using 20 ml of 0.75% Ropivacaine i.e., group R showed lesser duration of motor blockade than 0.5% levobupivacaine 20 ml i.e. group B in lower limb surgeries.