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4 - Comparison of efficiency of bupivacaine and ropivacaine in epidural anaesthesia in lower abdominal surgery
Şükrü Çiftçi, Ayşe Hancı, G. Ulufer Sivrikaya, Metin Bektaş, Sibel Oba
Objective: In our study we aimed to compare the characteristics of epidural block, peroperative haemodynamic changes and analgesia in early postoperative period in epidural anaesthesia produced by bupivacaine and ropivacaine for lower abdominal surgery.
Study design: After the approval of Medical Ethics Committe of our Hospital and written informed consent, 30 patients in ASA I-II undergoing inguinal hernia repair were included the study. Midazolam was used for premedication after IV fluid replacement. Epidural anaesthesia wps performed from L} 4 epidural space with loss of resistance method with 15 ml 0.5% bupivacaine in Group B and 15 ml 0.5% ropivacaine in Group R. Haemodynamic parameters (mean blood pressure, heart ra¬te), sensory and motor block levels, time to two segment regression of sensory block, postoperative analgesia at 2. and 6. hours (with Visuel Analogue Scale-VAS), time to first analgesic demand and adverse effects were recorded as study parameters.
Results: Haemodynamic parameters were lower peroperatively in two groups when compared with control values (p>0.05). Time to two segment reggression of sensory block was significantly longer and motor block degree was significantly higher in Group B than Group R (p<0.05). VAS values were comparable between the groups. Time to first analgesic demand was significantly shorter in Group R than Group B (p<0.05).
Conclusion: High degree of motor block and delay of regression of sensory block after epidural anaesthesia produced by bupivacaine in inguinal hernia repair was evaluated more effective on quality of anaesthesia and surgery peroperatively and analgesia postoperatively than produced by ropivacaine. On the other hand, epidural ropivacine can be an alternative to bupivacaine when less cardiotoxicity and early mobilization were aimed in such operations..
Keywords: Bupivacaine, ropivacaine, epidural.
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