Title: A Comparative Study of Post Operative Analgesic Efficacy of Levobupivacaine 0.1% versus Ropivacaine 0.1% Combined with Fentanyl under Epidural for Abdominal Surgeries
Authors: Arun Kumar P, Kalyan Chakravarthy P, Pradeep Kumar Das, Preethi Vaddi
DOI: https://dx.doi.org/10.18535/jmscr/v8i12.16
Abstract
Background: Levobupivacaine and Ropivacaine are pure S (-) Enantiomer of Bupivacaine. Both these new local anaesthetics have the advantage of lower degree of motor blockade, lesser cardio toxicity, thus making them a safer alternative to Bupivacaine. Fentanyl has been used commonly with Levobupivacaine and
Ropivacaine for further improvement in analgesia without intensifying adverse effects. In our study we compare the clinical efficacy and adverse effects of epidural Levobupivacaine with Ropivacaine both combined with Fentanyl following major abdominal surgery.
Methodology: All sixty patients after appropriate premedication and insertion of epidural catheter were allowed to undergo scheduled surgery under general anesthesia and extubated at the end of surgery. They were randomly allocated in to two groups to receive postoperative epidural infusion of either Levobupivacaine 0.1% with Fentanyl 2 µg/ml or Ropivacaine 0.1% with fentanyl 2 µg/ml for 48 hours. The efficacy was compared in terms of onset, quality of analgesia and residual motor blockade and any other adverse events.
Results: Pain scores were similar between the two groups. Mean VAS scores were consistently below 4 throughout the study period with no significant residual motor blockade (p>0.05).there was no significant hemodynamic changes and adverse effects between the two groups.
Conclusion: the study concludes that both local anaesthetics in combination with fentanyl provided satisfactory analgesia with minimal adverse effects.
Keywords: Epidural, Levobupivacaine, Ropivacaine, Fentanyl.
