Title : A study to compare bupivacaine and ropivacaine for postoperative analgesia in ultrasonography guided femoro sciatic nerve block in patients undergoing below knee surgery
Abstract:
Introduction- Postoperative pain following lower limb surgeries is distinct. Sciatic and femoral nerve blocks are highly useful in providing postoperative analgesia for lower limb surgeries. The use of ultrasound increases the efficacy of the procedure making it more reliable and decreasing the complication rate. Bupivacaine has a slow onset of action with a high rate of cardiac and neurotoxicity. Ropivacaine is a relativity new amide local anaesthetic and long-acting agent with a reduced potential for neuro and cardiotoxicity. Search for a lesser toxic alternative to bupivacaine was being investigated, thus it was decided to study ropivacaine in comparison to bupivacaine to evaluate the efficacy for the analgesia postoperatively.
Aim and objectives- The primary objective of the study is to compare duration of post-operative analgesia between the two groups. The secondary objective of the study is to note total analgesic consumption in the first 24 hours in both groups, the VAS in both the groups, the ease of administration of blocks and procedural complications, if any.
Methods- Fifty patients in the age group of 18-60 years belonging to ASA I and II who underwent elective lower limb below knee orthopaedic surgery, under subarachnoid SAB were included and randomly allocated to one of the two groups- Group B where patients were administered ultrasound guided femoral-sciatic nerve blocks with 20ml of 0.25% bupivacaine and Group R where patients were administered ultrasound guided femoral-sciatic nerve blocks with 20ml of 0.25% ropivacaine.
Result and conclusion- Ropivacaine and bupivacaine provided adequate and efficient analgesia in the postoperative period for below knee surgeries with a significantly longer duration for ropivacaine. Ropivacaine being a more cardio stable drug can be effectively used as an alternative to bupivacaine for femoro sciatic nerve block.
Audience Take Away Notes:
- It will help in providing better analgesia options for below knee surgery
- Less invasive option
- Better drug profile
- Early ambulation for patients
