Comparative Study between Epidural Ropivacaine and Epidural Bupivacaine with and without Fentanyl

Abstract

80 patients asal& Il undergoing minor surgery has been investigated using a double-blind comparison ofthe efficacies of ropivacaine and bupivacaine. this study investigated the•frequency of successful block, the timeto onset and duration of sensory and motor block. the hemodynamic profife ofbothdiugs has been investigated using the n,o invasive cardiac output monitor.NOCCOM3-7R Theiesuhs of this study demonstrate:In group I& 3, the meantime of onset of sensory loss was 5.4 ± 0.9 min for bupivac;tine and 6.4±0.7 min for ropivacaine.The maxiJnwn.height ofsensocy loss was 26.5 ± 12.8 min.& 31.5 ± 13.8 min respectively and the maximum level of sensory loss was T.4.for bupivacaine and T.6 for ropivacaine.The two segment regression time was !62.5 ± 30.8 min. for bupivacaine and 149 ± 15.3 min forropivacaine.The mean time of recovery of sensory block was 380 ± 37min for bupivacaine and 330 ± 31 min. for ropivacaine.The addition offentanyl to both groups i.e. group 2 & 4 did not change the data obtained as regards the maximum height and maximum level of sensory loss, as well as the two segl!lent regression time and the mean time of recovery of sensory block.The results of our study shows that out of20 patient, 5 patients has ascaleof2 i.e. 25% ancL\5 has ascala.oD I.e. 75% in the bupivacaine group.In the ropivacaine group 2 patients has a scale ofO and S•has a scale of 1,6 patients has a scale of2 and only 4 patients has a scale of3 i.e. 20%.Iagroup 2 & 4 the results are exactly the same as in group 1 & 2.This of course is due to the fact that fentanylhas no effect whatsoeve011.the motor power.The time to get a motor block for bupivacaine was 10 ± 7 and 25 ± 5 min for ropivacaine. To reach a maximum motor block we need 30 ± 13 min. for bupivacaine.and53 ± 14 min for ropivacaine. In the bupivacaine group 14 cases out of 40 (35%) developed significant lowering of systolic blood pressure, the other parameters e.g. cardiac index, ejection fraction, end diastolic index and systolic index, diminished to the same degree. The remainin_g cases. i.e. 26 patients (65%) shoes no changes in all the hemodynarni.c•pararneters. On the other hand, the ropivacaine group shows a lowering in all parameters in only 8 patients (20%), in the remaining 32 patients (80%) there was no change in all • . hemodynamic paramet rs.