BACKGROUNDThis prospective, randomised, double-blinded study compared the onset and duration of epidural anaesthesia produced by levobupivacaine and ropivacaine. MATERIALS AND METHODSSeventy adult patients of ASA physical status I and II were divided into two groups of 35 each by pre-decided randomisation schedule, Group R to receive epidural isobaric ropivacaine 0.5% 15 mL combined with 50 mcg fentanyl and Group L to receive epidural isobaric levobupivacaine 0.5% 15 mL combined with 50 mcg fentanyl. A blinded observer evaluated onset and regression of motor and sensory block, and requirement of rescue analgesia. RESULTSOnset of sensory block was comparable in both groups. Onset of motor block was longer in group R (18.4+/-1.77 min. in Group R vs. 15.69 +/-0.76 min. in group L). In both groups, maximum sensory level reached was T5. Duration of motor block was found to be significantly shorter in group R as compared to group L (175.9+/-8.53 min. in Group L vs. 150.9+/-7.12 min. in Group R). Duration of analgesia was comparable in both groups (231.0+/-9.2195 min. in Group L and 233.54 +/-8.4064 min. in Group R). Haemodynamic variables were comparable in both groups. CONCLUSIONSLevobupivacaine 0.5% produced a sensory block of similar onset, quality, and duration as ropivacaine 0.5% but a longer duration of motor block. KEYWORDS BACKGROUNDAs perioperative physicians, anaesthesiologists are responsible for proper pain management during the perioperative period, creation of innovative approaches to acute pain management, and extending their care for acute postoperative pain services as well. A variety of neuraxial and peripheral regional analgesic techniques are being used for effective perioperative analgesia. In general, the analgesia provided by epidural and peripheral techniques is superior to that with only systemic opioids, 1 with reduced morbidity and mortality. 2,3 Regional anaesthesia offers several advantages over general anaesthesia -provides excellent intraoperative analgesia, blunts stress response to surgery, decreases intraoperative
Background: The most signicant use of ONB i.e., obturator nerve block is to prevent adductor muscle contraction associated with Transurethral resection of bladder tumours (TURBT). Adductor jerk during TURBT may cause serious injury to urinary bladder like laceration with involvement of blood vessels, severe bleeding, bladder wall tear and perforation and even partial resection of bladder tumour due to frequent distraction and interruption to the surgeon.1 So, there is need for evaluation and comparison of different techniques of ONB in view of safety and efcacy. We have conducted a randomized clinical study to compare the classic pubic and inter adductor approach for ONB with spinal anaesthesia for transurethral resection of bladder wall tumour masses. Method: A total number of 50 patients of either sex of ASA physical status I or II, of age group 30-75 years, who were posted for TURBT operation under spinal anaesthesia, were included in this study. A Prospective single blind randomised controlled trial and cross over study was conducted. Peripheral nerve stimulator to localize the nerve and Inj. Ropivacaine 0.5% ,15 ml on each side was used in this study. Result: The overall success rate in classic pubic approach was slightly lower than interadductor approach which was statistically insignicant. There were more instances of vessel puncture in pubic approach, which was statistically signicant (p value = 0.016). There was no incidence of other signicant complications. Conclusion: In terms of ease of obturator nerve block and incidence of complications the interadductor approach is better than classic pubic approach.
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