Title: Comparison of 0.75%Isobaric Ropivacaine Alone And 0.75%Isobaric Ropivacaine with Fentanyl as Adjuvant in Spinal Anesthesia for Orthopaedic Lower Limb Surgeries
Authors: Mudita Bhatia, Alaka Purohit, Mohit Pareek, Pradeep Charan
DOI: https://dx.doi.org/10.18535/jmscr/v5i6.158
Abstract
Background: Fentanyl, a potent, short acting, synthetic opioid analgesic has been commonly used as an adjuvant with local anesthetics for post operative analgesia because of its superior intraoperative conditions, hemodynamic stability and minimal side-effects.
The aim of this study was to evaluate the efficacy and safety of addition of Intrathecal Fentanyl to 0.75% Isobaric Ropivacaine in spinal anesthesia in orthopaedic lower limb surgeries.
Subjects and Methods: Hundred patients belonging to American Society of Anesthesiologists physical status I and II scheduled for orthopedic lower limb surgery under spinal anesthesia were included. The study was a prospective double blinded randomized controlled trial where patients were randomly allocated into two groups of fifty patients each to receive either 2.6 ml of 0.75% (19.5 mg) isobaric ropivacaine with 0.4ml (20 μg) fentanyl (Group B) or 2.6 ml of 0.75% (19.5 mg) isobaric ropivacaine with 0.4 ml of 0.9% saline (Group A) intrathecally. The points studied were hemodynamic parameters, onset of sensory and motor blockade, duration of sensory and motor blockade, duration of analgesia, degree of sedation and side-effects were also assessed. At the end of study, data were systematically compiled and analyzed for statistical significance.
Results: No significant difference was found in hemodynamics, onset of sensory block and incidence of side effects with the addition of fentanyl to ropivacaine. The intrathecal fentanyl has accelerated the onset time to achieve motor blockade. There was a significant prolongation of the duration of sensory block and postoperative analgesia in Group B.
Conclusion: Intrathecal 20μg fentanyl is associated with prolonged sensory block, provides excellent quality of intraoperative and postoperative analgesia allowing early and pain free ambulation as compared to plain ropivacaine. It is haemodynamically stable in intraoperative and postoperative periods with insignificant side effects.
Keywords: Ropivacaine, Bupivacaine, Fentanyl, Spinal anesthesia.
