A prospective randomised trial comparing the analgesic efficacy of postoperative infusion of epidural bupivacaine and ropivacaine in orthopaedic surgeries

Jisha M, Kannan D, Koti S, Polavarapu R, Arunpandiyan V

Pdf Page Numbers :- 153-158

Jisha M^1,*, Kannan D², Srikanth Koti³, Rikesh Polavarapu⁴ and Veerapandiyan Arunpandiyan⁵

¹Department of Anaesthesiology, Integrated Institute of Medical Sciences, Palakkad, Kerala, India

²Anaesthesiology, Meenakshi Mission Hospital and Research Centre, Madurai, Tamil Nadu, India

³Critical Care Medicine, Aayush Hospitals, Vijayawada, Andhra Pradesh, India

⁴Cardiac Anaesthesia, Apollo Hospital, Madurai, Tamil Nadu, India

⁵Anaesthesiology and Intensive care, Erode Medical Centre, Erode, Tamil Nadu, India

*Corresponding author: Dr. Jisha M, Assistant Professor, Department of Anaesthesiology, Integrated Institute of Medical Sciences, Palakkad, Kerala-678013, India. Email: drjisham80@gmail.com

Received 4 February 2022; Revised 25 April 2022; Accepted 16 May 2022; Published 27 May 2022

Citation: Jisha M, Kannan D, Koti S, Polavarapu R, Arunpandiyan V. A prospective randomised trial comparing the analgesic efficacy of postoperative infusion of epidural bupivacaine and ropivacaine in orthopaedic surgeries. J Med Sci Res. 2022; 10(3):153-158. DOI: http://dx.doi.org/10.17727/JMSR.2022/10-28

Copyright: © 2022 Jisha M et al. Published by KIMS Foundation and Research Center. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Abstract

Background: Epidural administration of local anaesthetic provides effective pain relief. Commonly used epidural local anaesthetics are bupivacaine and ropivacaine. Most studies compared these drugs along with an opioid or any other adjuvants like clonidine, dexmedetomidine etc. Our aim was to compare the analgesic efficacy and safety of continuous infusion of epidural ropivacaine and bupivacaine without any adjuvants in postoperative patients.

Materials and methods: A prospective randomized clinical study was conducted in a tertiary care hospital in 60 patients between the age groups of 20-years and 60-years undergoing elective lower limb orthopaedic procedures. Total patients were divided into two groups (A and B) of 30 each. Continuous epidural infusion was started with 6ml per hour of 0.125% bupivacaine in Group A and 6ml per hour of 0.2% ropivacaine in Group B postoperatively. After the commencement of epidural infusions, heart rate, blood pressure, Visual Analogue Score (VAS) and supplementary analgesic requirement were monitored postoperatively for 48 hrs.

Results: Our observations showed no significant difference in haemodynamic parameters like heart rate and blood pressure. VAS showed a statistically significant difference with higher mean VAS score in Group B patients at one hour (p value = 0.0126), 12 hrs (p value = 0.031) and 24 hrs (p value = 0.0421) as compared to Group A. Add on analgesic requirement was also higher for Group B patients.

Conclusions: Both bupivacaine and ropivacaine can be used effectively for postoperative analgesia but bupivacaine has a superior analgesic efficacy than ropivacaine with similar safety profile.

Keywords: bupivacaine; ropivacaine; epidural; analgesia