A COMPARISON OF HYPERBARIC ROPIVACAINE ALONE VS HYPERBARIC ROPIVACAINE WITH FENTANYL OR MIDAZOLAM FOR SPINAL ANESTHESIA

Abstract

Ropivacaine, an amide local anesthetic agent with similar local anesthetic properties as bupivacaine, has been studied for intrathecal use. The current study compared the clinical efficacy of intrathecal fentanyl and midazolam when added to hyperbaric ropivacaine, evaluating the effect of each on the duration and quality of spinal blockade produced by hyperbaric ropivacaine. This study was conducted on ninety (90) patients of class I and class II of the American Society of Anesthesiologists (ASA) classification, who were scheduled for elective lower limb surgery. Patients are randomly assigned into three groups (30 patients each): according to type of local anesthetic used. This study showed stability of all hemodynamic and respiratory parameters measured in the three groups during intraoperative and postoperative periods As regards to sensory block, it was significantly prolonged in both ropivacaine-fentanyl and ropivacaine-midazolam groups than ropivacaine only group, for motor block, there was no significant difference between the three groups and for postoperative sedation, there was no significant difference between the three groups. Ropivacaine–midazolam group showed comparable results to ropivacaine-fentanyl group avoiding pruritis seen with ropivacaine-fentanyl group. Both groups showed better results than ropivacaine group in duration of sensory block and analgesic requirement in the early post-operative period.