Comparative study of clinical efficacy and safety of intrathecal isobaric ropivacaine 0.75% with fentanyl versus isobaric ropivacaine 0.75% alone for caesarean
Keywords:Spinal anesthesia, Cesarean section, Ropivacaine with fentanyl, Ropivacaine with normal saline, Intrathecal
Background: Compare the clinical efficacy and safety of intrathecal isobaric ropivacaine 0.75% with fentanyl, 10 mcg vs isobaric ropivacaine 0.75% alone for caesarean section.
Methods: Two hundred patients were considered eligible for the study of which one hundred and sixty-eight patients undergoing caesarean section under spinal anesthesia and were included in the study. Parturient to ASA physical status I-II scheduled for caesarean section were randomly selected for the study and are divided into group of 84 each.
Results: There was significant difference in sensory block duration at T10 (min) and total duration of analgesia (min) in both groups. This difference between two group’s was not significant. Adverse Effects in group RF 5 (5.9%) patients had hypotension and 2 (2.3%) bradycardias in group R 3 (3.5%) patient had hypotension.
Conclusions: Hemodynamic parameters were comparable in both the groups. Total duration of analgesia and sensory block duration at T10 was significantly shorter with ropivacaine (with saline) compared to ropivacaine with fentanyl.
Wille M. Intrathecal use of ropivacaine: A review. Acta Anaesthesiol Belg. 2004;55(3):251-9.
Bang EC, Lee HS, Kang YI, Cho KS, Kim SY, Park H. Onset of labor epidural analgesia with ropivacaine and a varying dose of fentanyl: A randomized controlled trial. Int J Obstet Anesth. 2012;21(1):45-50.
Boztug N, Bigat Z, Ertok E, Erman M. Intrathecal ropivacaine versus ropivacaine plus fentanyl for out-patient arthroscopic knee surgery. J Int Med Res. 2005;33(4):365-71.
De Kock M, Gautier P, Fanard L, Hody JL, Lavand’homme P. Intrathecal ropivacaine and clonidine for ambulatory knee arthroscopy: A dose-response study. Anesthesiol. 2001;94(4):574-8.
McDonald SB, Liu SS, Kopacz DJ, Stephenson CA. Hyperbaric spinal ropivacaine: A comparison to bupivacaine in volunteers. Anesthesiol. 1999;90(4):971-7.
Bawdane KD, Magar JS, Teldonkar BA. Double blind comparison of combination of 0.1% ropivacaine and fentanyl to combination of 0.1% bupivacaine and fentanyl for extradural analgesia in labour. J Anaesthesiol Clin Pharmacol. 2016;32(1):38-43.
Gautier E, DeKock M, Van Steenberge A, Pont N, Lahaye-Goffart. Intrathecal ropivacaine for ambulatory surgery. Anaesthesiol. 1999;91(5):1239-45.
Malinovsky JM, Charles F, Kick O, Lepage JY, Lepage JY, Cozian A et al. Intrathecal anaesthesia: Ropivacaine versus bupivacaine. Anaesth Analg. 2000;91(6):1457-60.
Ayorinde BT, Buczkowski P, Brown J, Shah J, Buggy DJ. Evaluation of preemptive intramuscular phenylephrine and ephedrine for reduction of spinal anaesthesia induced hypotension during ceaserean section. Br J Anaesth. 2001;86(3):372-6.
Khaw KS, Ngan Kee WD, Wong ELY, Liu JYW, Chung R. Spinal ropivacaine for cesarean section. Anesthesiol. 2001;95:1346-50.
Sanli S, Yegin A, Kayacan N, Yilmaz M, Coskunfirat N, Karsli B. Effects of hyperbaric spinal ropivacaine for caesarean section: with or without fentanyl. Eur J Anaesthesiol. 2005;22(6):457-61.
Yegin A, Sanli S, Hadimioglu N, Akbas M, Karsli B. Intrathecal fentanyl added to hyperbaric ropivacaine for transurethral resection of the prostate. Acta Anaesthesiol Scand. 2005;49(3):401-5.
Chung CJ, Yun SH, Hwang GB, Park JS, Chin YJ. Intrathecal fentanyl added to hyperbaric ropivacaine for cesarean delivery. Reg Anesth Pain Med. 2002;27(6):600-3.
Mohta M. Ropivacaine: Is it a good choice for spinal anesthesia? J Anaesthesiol Clin Pharmacol. 2015;31(4):457-8.