Kumar Ashish, Kumar Rajesh, Kumar Rajnish, Koshire Alka
Department of Anaesthesiology, AIIMS, Patna, Bihar, India.
Department of Anaesthesiology, Dr. Vasant Rao Pawar Medical College and Research Centre, Nashik, Maharashtra, India.
Anesth Essays Res. 2019 Oct-Dec;13(4):688-691. doi: 10.4103/aer.AER_142_19. Epub 2019 Dec 16.
The aim of the study was to compare the effectiveness of ropivacaine (0.5%) and bupivacaine (0.5%) in epidural neuraxial blockade for elective lower abdominal surgeries.
The present study was conducted in sixty patients undergoing elective lower abdominal surgeries under epidural anesthesia who were included after satisfying the eligibility criteria. The patients were randomly divided into two groups. An epidural catheter was inserted in cephalad direction using Tuohy epidural needle at L-L or L-L with the help of loss of resistance to air technique. Twenty milliliter of the study drug was given, sensory blockade was tested using the pinprick method, and quality of motor blockade was assessed by the modified Bromage scale.
In our study, demographic data comparing age and sex show no statistically significant difference among both the groups. In our study, the mean time for the onset of sensory block consider at T in Group B was 10.05 ± 2.1 min and in Group R was 9.8 ± 1.8 min. Moreover, the mean time duration of sensory block in Group B was 5.56 ± 0.059 h and in Group R was 5.34 ± 0.073 h. The onset of motor block in Group B was 4.98 ± 1.07 min and in Group R was 5.28 ± 1.2 min, but the duration of motor block for Group B was 4.63 ± 0.39 h and for Group R was 3.53 ± 0.23 h, which is clinically and statistically significant. The maximum level of sensory blockade for Group B was T and for Group R was T. The range of block in Group B was T-T and in Group R was T-T.
The onset of sensory block was comparable in both the group, but the duration of sensory block is shorter with ropivacaine compared to bupivacaine. The onset of motor blockade was comparable in both the groups, but the duration of motor blockade was also shorter and the degree of motor block was less intense with ropivacaine compared to bupivacaine.
本研究旨在比较罗哌卡因（0.5%）和布比卡因（0.5%）在择期下腹部手术硬膜外神经阻滞中的有效性。
本研究纳入了60例在硬膜外麻醉下接受择期下腹部手术且符合入选标准的患者。患者被随机分为两组。在L2-L3或L3-L4间隙，借助空气阻力消失技术，使用Tuohy硬膜外穿刺针向头端插入硬膜外导管。给予20毫升研究药物，采用针刺法测试感觉阻滞情况，并通过改良的Bromage量表评估运动阻滞质量。
在我们的研究中，比较年龄和性别的人口统计学数据显示两组之间无统计学显著差异。在我们的研究中，B组T10感觉阻滞起效的平均时间为10.05±2.1分钟，R组为9.8±1.8分钟。此外，B组感觉阻滞的平均持续时间为5.56±0.059小时，R组为5.34±0.073小时。B组运动阻滞的起效时间为4.98±1.07分钟，R组为5.28±1.2分钟，但B组运动阻滞的持续时间为4.63±0.39小时，R组为3.53±0.23小时，这在临床和统计学上具有显著意义。B组感觉阻滞的最高平面为T6，R组为T7。B组的阻滞范围为T4-T6，R组为T5-T7。
两组感觉阻滞的起效情况相当，但与布比卡因相比，罗哌卡因的感觉阻滞持续时间较短。两组运动阻滞的起效情况相当，但与布比卡因相比，罗哌卡因的运动阻滞持续时间也较短，且运动阻滞程度较轻。
