TO COMPARE THE EFFECTS, SAFETY AND EFFICACY OF ROPIVACAINE AND LEVOBUPIVACAINE IN PARAVERTEBRAL BLOCK

Dr. Roopesh Kumar; Dr. Shivali Pandey; Dr. Amit Kumar Niranjan; Dr. Brajendra Verma

Volume : X, Issue : VI, June - 2020

TO COMPARE THE EFFECTS, SAFETY AND EFFICACY OF ROPIVACAINE AND LEVOBUPIVACAINE IN PARAVERTEBRAL BLOCK

Dr. Roopesh Kumar, Dr. Shivali Pandey, Dr. Amit Kumar Niranjan, Dr. Brajendra Verma

Abstract :

Introduction: A paraverteal block is essentially a unilateral block of the spinal nerve, including the dorsal and ventral rami, as well as the sympathetic chain ganglia. These blocks can be performed at any verteal level. However, they are most commonly performed at the thoracic level because of anatomic considerations. Aim: To compare the effects, safety and efficacy of ropivacaine (0.75%) and levobupivacaine (0.5%) in single injection thoracic paraverteal block Material and Methods: This single blind, prospective, randomized study was conducted in Department of Anaesthesiology and Critical Care, Maharani Laxmi Bai Medical College, Jhansi (UP). Following approval of ethical committee, patients admitted for east surgery, between the age of 18 and 65 yrs., belonging to ASA grade 1 and 2 were taken as subjects of study. All the selected patients were subjected to a detailed history and clinical examination along with all routine investigations including Hb, T.L.C., D.L.C., Blood urea, serum creatinine, and urine examination. Specific investigations were prescribed as and when required. Result: The patients who were accepted for study were in age group 18–65 years with reference to table 1 and 2, there is no significant difference in age in Group A (31.57±7.70) and Group B (31.87±10.12). The mean onset of complete sensory block during present study was found to be early with 0.75% Ropivacaine (Group A) (11.50±2.85 min) then 0.5% Levobupivacaine (Group B) (12.87±3.09 min) and comparison among than was found to be non significant [p value=0.0796]. Where as mean duration of sensory block was found longer with 0.5% Levobupivacaine (641.3±36.3 min) then 0.75% Ropivacaine (613±58.46 min) and comparison found to be significant [p value=0.0280]. Mean duration of post operative analgesia also found longer with 0.5% Levobupivacaine (680±35.13 min) then 0.75% Ropivacaine (652.±53.43 min) and comparison found to be significant [p value=0.0227]. After analyzing SBP, DBP and mean blood pressure variation and pulse oximetry for pulse rate and arterial oxygen saturation, it was found that both of the study group did not show hemodynamic instability. Only one patient in Levobupivacaine group developed complication, but overall hemodynamics remained fairly stable and comparable in both group. No any sign of drug toxicity or drug reaction was reported in any patients. Conclusion: It can therefore be said that, Inj. Ropivacaine 0.75% is beneficial in respect to earlier onset and Inj. Levobupivacaine 0.05% have longer duration of sensory block and post operative analgesia but there were no much clinical difference in onset, duration, post operative analgesia among 0.75% Ropivacaine and 0.5% Levobupivacaine, when injected in equal volumes for PVB