Document Type : Research Article
Abstract
Background: Different adjuvants are coadministered with local anesthetics to improve the speed of onset and duration of analgesia, and to reduce the dose, the selection of which is often left to the choice of an anesthesiologist.
Aims: Aim of the study is to evaluate the efficacy &safety of 0.75% Ropivacaine in epidural anaesthesia for lower abdominal surgeries.
Materials and methods: In the present clinical study, 0.75% preservative free ropivacaine is used through epidural route for patients undergoing elective lower abdominal surgeries belonging to ASA grade I and II with in the age group of 20 to 60 years.
We observed the time of onset , highest cephalad spread, two segment regression from highest cephalad spread and total duration of sensory block as well as degree of motor blockade and it's duration, haemodynamic changes, duration of post operative analgesia and side effects , if any.
Results: With 0.75% preservative free ropivacaine, the mean onset time of sensory block for S1, L1, T10, andT6 dermatomal levels are 22.9+/-5.01 mins, 8.48+/- 3.18 mins, 13.4+/-3.88 mins and 29.5+/-3.33 mins respectively. The maximum cephalad spread is T5 dermatomal level and mean time to reach maximum cephalad spread is 29.77+/-4.94 minutes.
The mean duration of sensory blockade and motor blockade are 406.25 +/- 23.22 minutes and 263.58 +/- 21.19 minutes respectively. The motor blockade time is far less than the sensory blockade. Only 6.66% of the total patients achieved the Modified Bromage scale3.
In our present study, the mean total duration of postoperative analgesia is 246.67+/- 42.86 minutes. There are not many changes in the haemodynamics and incidence of side effects and requirement of vasoactive drugs were minimal.
Conclusions: 0.75% ropivacaine has a longer duration of sensory blockade and the duration of motor blockade is for less than the sensory blockade, their by providing post operative analgesia for nearly more than four hours. It appears to be an ideal and safe local anaesthetic for these surgeries.