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ORIGINAL ARTICLE
Year : 2022  |  Volume : 16  |  Issue : 2  |  Page : 238-243

Comparative study between intrathecal 0.5% isobaric levobupivacaine, 0.5% isobaric ropivacaine, and 0.5% hyperbaric bupivacaine in elective lower segment cesarean section: A randomized clinical study


1 Department of Anesthesiology, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
2 Department of Critical Care Medicine, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
3 Department of Critical Care, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India

Correspondence Address:
Dr. Barun Ram
Trauma Critical Care, Rajendra Institute of Medical Sciences, Ranchi - 834 009, Jharkhand
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/aer.aer_60_22

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Background: Neuraxial anesthesia in obstetrics began with the spinal block by Oskar Kreis in 1900. The technique of subarachnoid blockade has been refined since then and various drugs have been used to provide analgesia and anesthesia for infraumbilical surgeries. Materials and Methods: This study was conducted because of newer options available, such as an intrathecal drug with appropriate sensory and motor blockade and minimal haemodynamic changes that can be used in the lower segment cesarean section safely. Ninety patients were randomly divided into three groups including 30 patients in each group. Group B, Group L, and Group R, each receiving 2.2 mL of 0.5% hyperbaric bupivacaine, 0.5% isobaric levobupivacaine, and 0.5% isobaric ropivacaine, respectively. All groups were compared concerning sensory block, motor block, hemodynamic stability, and complications if any. Results: The onset of sensory block at T8, two-segment regression time from the highest block, time of regression to L1, total duration of analgesia, onset and total duration of motor block were comparable between Group B and L (P > 0.05), but both these groups were statistically significant with Group R (P < 0.05). Hypotension was observed among all the groups; however, the incidence was minimum in Group R. Conclusion: 12 mg of isobaric ropivacaine and 12 mg of isobaric levobupivacaine, compared to 12 mg hyperbaric bupivacaine (2.2 mL of 0.5% each), when administered intrathecally provides adequate anesthesia for cesarean section. The lesser duration of motor block in ropivacaine compared to the other two drugs could be beneficial for early ambulation, also the incidence of hypotension was lower in Group R.


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