Comparison of anaesthetic potency of intrathecal isobaric ropivacaine with and without fentanyl for lower abdominal and lower limb surgeries

Jasleen Kaur; Kirti Rishi

Volume : VI, Issue : VII, July - 2017

Comparison of anaesthetic potency of intrathecal isobaric ropivacaine with and without fentanyl for lower abdominal and lower limb surgeries

Jasleen Kaur, Kirti Rishi

Abstract :

Background: The addition of intrathecal opioids to local anaesthetics have been shown to enhance the sensory blockade and improve the quality of subarachnoid block.

Material and Methods: This prospective, double–blind randomized controlled study was conducted in 60 patients in the age group of 20 – 60 yrs, belonging to American Society of Anaesthesiologists (ASA) physical status I and II scheduled for lower abdominal and lower limb surgeries under subarachnoid block. Patients were randomly allocated into two groups to receive either intrathecal 3.5ml of isobaric ropivacaine 0.75% (Group R) or 3ml of isobaric ropivacaine 0.75% with 0.5ml (25mcg) fentanyl (Group RF). Demographic data, hemodynamic profile, sensory and motor block characteristics, complications and time to first postoperative analgesic requirement were compared in the two groups.

Results: The onset of sensory blockade was faster in Group RF (4.56 � 1.36 min) as compared to Group R (6.7 � 1.08 min. Time to reach T10 dermatome and the maximum level of sensory block attained were comparable. Regression of sensory blockade to S2 dermatome was 306.5 � 39.25 min in Group RF and 230.05�17.05 min in Group R ( P <0.05).Onset of motor blockade was earlier and regression was delayed in Group R as compared to Group RF. Time to first post–operative analgesic requirement was significantly prolonged in Group RF (222.25 � 48.05 min) than Group R (195.9 � 31.60 min). Hemodynamic parameters and complications were comparable.

Conclusion: The addition of intrathecal fentanyl to ropivacaine enhances the onset of sensory blockade and prolongs the postoperative analgesia with stable hemodynamics and minimal side effects.