Ropivacaine has recently been introduced in Indian pharmacopeia. Ropivacaine, the S-enantiomer of Npropylpipecolic acid 2,6-xylidine, is an amide local anaesthetic 1 that is less cardio toxic than bupivacaine. Like other local anaesthetics ropivacaine elicits nerve block via reversible inhibition of sodium ion influx in nerve fibres. It has lower lipid solubility and is less likely than bupivacaine to penetrate large myelinated motor fibres. The degree of ropivacaine induced 2,3 sensory and motor block are dose and age dependant. Ropivacaine presumably produces less central nervous toxicity 2,3 and cardiac toxicity than bupivacaine. It blocks C-fibres faster than A fibers, but the blockade of A fibers is less with ropivacaine than a similar concentration of bupivacaine, whereas the degree 4,5 of C-fibre block was similar with both drugs. The analgesic potency of ropivacaine is similar to that of bupivacaine while 6,7 motor block is less pronounced and of shorter duration. This study was designed in a randomized double blind fashion to compare the clinical effectiveness of ropivacaine and bupivacaine in patients undergoing lower extremity and lower abdominal surgeries.BACKGROUND: Ropivacaine, a derivative of mepivacaine like its older counterpart Bupivacaine, has recently been introduced in Indian pharmacopeia. Ropivacaine is an amide local anaesthetic but less cardiotoxic than bupivacaine.
OBJECTIVE: To compare the clinical effectiveness of ropivacaine versus bupivacaine in patients undergoing lower extremity and lower abdominal surgeriesMETHODS: 50 patients were randomized to receive 20ml of 0.5% ropivacaine or 0.5% bupivacaine through epidural catheter. Sensory (pinprick) and motor (bromage) measurements were made while the block was in effect, haemodynamic changes; use of additional analgesics and sedatives was noted.
RESULTS:The quality and extent of sensory and motor blockade between the two groups was comparable, although bupivacaine was found to be slightly longer acting. Both had similar motor blocking characteristics, with the exception that bupivacaine had a blockade of slightly longer duration but statistically not significant (p>0.05).
CONCLUSION:Ropivacaine being lesser cardio toxic is the preferred agent for clinical epidural anaesthesia. JMS 2011;14(1):15-18
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