AN OBSERVATIONAL STUDY TO COMPARE   ROPIVACAINE AND BUPIVACAINE ALONG WITH TRAMADOL TO PROVIDE POST OPERATIVE EPIDURAL ANALGESIA IN PATIENTS UNDERGOING ELECTIVE PYELOLITHOTOMY SURGERY.

Dr. Parthav Patel; Dr. Chaitree Shah; Dr. Rama Upadhyaya

Volume : VI, Issue : VIII, August - 2016

AN OBSERVATIONAL STUDY TO COMPARE ROPIVACAINE AND BUPIVACAINE ALONG WITH TRAMADOL TO PROVIDE POST OPERATIVE EPIDURAL ANALGESIA IN PATIENTS UNDERGOING ELECTIVE PYELOLITHOTOMY SURGERY.

Dr. Parthav Patel, Dr. Chaitree Shah, Dr. Rama Upadhyaya

Abstract :

‘AN OBSERVATIONAL STUDY BETWEEN 0.125% ROPIVACAINE AND 0.125% BUPIVACAINE ALONG WITH TRAMADOL TO PROVIDE POST OPERATIVE EPIDURAL ANALGESIA IN PATIENTS UNDERGOING ELECTIVE PYELOLITHOTOMY SURGERY’AIMS AND OBJECTIVES: The aim of this study was to compare the analgesic effect, duration of action and hemodynamic changes of 0.125% Bupivacaine with that of 0.125% Ropivacaine along with tramadol in patients undergoing pyelolithotomy for post–operative analgesia.MATERIAL AND METHODS : 60 patients were taken scheduled for pyelolithotomy surgery ranging from 18–55 years in ASA grade I and II. Clearance from institutional ethics committee was obtained. They were randomly allocated to two groups of 30 each. An epidural catheter was introduced in L1–L2, L2–L3 space under strict aseptic and antiseptic precautions. First dose of the study drug was given to all patients at the time of closure.Group R (n = 30) received an Epidural loading dose of 10ml 0.125% of Ropivacaine with 50mg tramadol.Group B (n =30) received an Epidural loading dose of 10ml 0.125% Bupivacaine with 50mg tramadol. • All the patients were induced with Inj. Propofol 2mg/kg, Inj. Succinylcholine 2mg/kg followed endotracheal intubation by direct layringoscopy. Tube was fixed after checking bilateral air entry. • Patient were maintained on O2/N2O 50%–50% with isoflorane and Inj. Atracurium 0.5 mg/kg bolus followed by intermittent dose as per train of four responses. Intraoperative fluid were calculated and managed. • Patients were reversed with Inj. neostigmine and Inj. glycopyrrolate and Extubated. • Patients were assessed post–operatively every 15 min for heart rate, blood pressure,spo2 for first hour and then after every 30 min till patient complained of pain. Pain was assessed by visual analogue scale. RESULT:The R Group experienced significantly longer duration of effective postoperative analgesia, with significantly shorter duration of motor blockade and lesser total analgesic requirement in comparison to the B Group. Hemodynamicaly, patients in both the groups, were equally stable CONCLUSION: Ropivacaine, with an equipotent analgesic efficacy and a lesser duration of motor block, however, a similar hemodynamic and side–effect profile. Thus, Ropivacaine can be used as an alternative to Bupivacaine for postoperative pain relief through the epidural route in patients undergoing pyelolithotomy ,as a safe and effective agent.