title: Hyperbaric spinal ropivacaine in lower limb and hip surgery: A comparison with hyperbaric bupivacaine.
abstract: OBJECTIVE
  Bupivacaine is more cardiotoxic than ropivacaine. Ropivacaine provides effective spinal anesthesia for lower limb and hip surgeries. This prospective study was designed to compare the efficacy and safety of intrathecal hyperbaric ropivacaine with hyperbaric bupivacaine for patients undergoing limb and hip surgeries.
  
  
  METHODS
  Two hundred patients aged 40-75 years, with American Society of Anesthesiologists I and II of either gender were randomly divided into Group R (Ropivacaine) and Group B (Bupivacaine) to receive an intrathecal injection of 3 ml of hyperbaric ropivacaine 0.5% or 3 ml of hyperbaric bupivacaine 0.5%, respectively. Onset and duration of sensory blockade were determined using the pinprick method by a three-point scale at T-10 dermatome. Onset and duration of motor block were assessed by modified Bromage scale. Duration of postoperative analgesia, hemodynamic changes, central nervous system and cardiovascular system toxicity or any adverse effects were observed.
  
  
  RESULTS
  The mean onset of sensory block (6 ± 1.3 min vs. 3 ± 1.1 min; P < 0.001) and motor block (13 ± 1.6 min vs. 9 ± 1.3 min; P < 0.05) was significantly slower in ropivacaine group as compared to bupivacaine group. The total duration of sensory block was significantly shorter in the ropivacaine group (160 ± 12.9 min) than in the bupivacaine group (260 ± 16.1 min; P < 0.05). The mean duration of motor block was also shorter in the ropivacaine group compared to bupivacaine group (126 ± 9.2 min vs. 174 ± 12.6 min; P < 0.05). Quality of anesthesia was comparable in two groups (P = 0.04).
  
  
  CONCLUSIONS
  We conclude that hyperbaric bupivacaine used intrathecally has a faster onset of sensory block and prolonged duration of analgesia compared to hyperbaric ropivacaine.
authors.affiliation: Department of Anesthesiology, Sher-e-Kashmir Institute of Medical Sciences, Medical College Hospital, Bemina, Srinagar, Jammu and Kashmir, India.
authors.forename: Feroz Ahmad
authors.initials: FA
authors.lastname: Dar
authors.affiliation: Department of Anesthesiology, Sher-e-Kashmir Institute of Medical Sciences, Medical College Hospital, Bemina, Srinagar, Jammu and Kashmir, India.
authors.forename: Mohsin Bin
authors.initials: MB
authors.lastname: Mushtaq
authors.affiliation: Department of Anesthesiology, Sher-e-Kashmir Institute of Medical Sciences, Medical College Hospital, Bemina, Srinagar, Jammu and Kashmir, India.
authors.forename: Umar Mushtaq
authors.initials: UM
authors.lastname: Khan
keywords: Bupivacaine; hyperbaric; ropivacaine; spinal anesthesia