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A COMPARISON OF SPINAL HYPERBARIC ROPIVACAINE AND HYPERBARIC BUPIVACAINE FOR ELECTIVE CESAREAN SECTION

Department of Anesthesia, University of Manitoba, LB315-60 Pearl St, Winnipeg, MB, R3E 1X2.

INTRODUCTION:

We compared hyperbaric bupivacaine with hyperbaric ropivacaine for elective cesarean section in a double blind, randomized study. We determined the efficacy and the duration of motor blockade for the two agents.

METHODS:

The University of Manitoba Ethics Committee and the Research Review Boards of the Health Science Center and St. Boniface General Hospital approved the study. Sixty-six parturients were assigned to receive either 11.25 mg of hyperbaric bupivacaine or 15 mg of hyperbaric ropivacaine. All spinal anesthetics also contained 0.1mg of morphine and 0.01 mg fentanyl. We assessed sensory block with ice and motor block with the Bromage scale¹ at 3, 6, and 9 min after injection. We recorded APGAR scores, cord gases, and hypotension, vomiting, nausea, pain and pruritus intra-operatively. Patients were followed in PACU at 15-minute intervals until full motor function and sensation to L₄ returned. We obtained the obstetricians’ assessments of the anesthetics. All patients were interviewed at 24 hours. Results are presented as mean ± standard deviation.

RESULTS:

Demographics were not different between the two groups. The median level of sensory blockade (ropivacaine-T₃, bupivacaine-T₂) did not differ. Duration of sensory block was shorter in the ropivacaine group (174 ± 24 min vs. 217 ± 46 min; P< .0001). Time for sensory block to recede to T₁₀ (50 ± 10 min vs. 75 ± 15 min; P< 0.0001) and duration of motor block (85 ± 26 vs. 159 ± 56 min; P< .0001) was shorter in the ropivacaine group. The obstetricians rated intra-operative anesthesia as excellent in both groups. Side effects did not differ between the two groups. The patients in the ropivacaine group expressed significantly greater satisfaction compared to the bupivacaine group (P< .0016).

DISCUSSION:

We have determined that 15 mg of hyperbaric ropivacaine with 0.1 mg morphine and 0.01 mg fentanyl, provided excellent intra-operative anesthesia for cesarean section. The advantages of hyperbaric ropivacaine are faster regression of the block and greater patient satisfaction.

REFERENCES:

1 Epidural analgesia. WB Saunders, 1978:301–3.

This Article Full Text (PDF) Submit a scholarly reply Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Al-Abdulhadi, O. A Articles by Boker, A. Search for Related Content PubMed Articles by Al-Abdulhadi, O. A Articles by Boker, A.