Comparative Study between Intrathecal Hyperbaric and Isobaric Ropivacaine in Geriatric Patients, Undergoing Lower Limb Plastic Surgical Procedures

Introduction: Ropivacaine is one of the commonest drugs used for spinal anaesthesia. We conducted a study comparing characteristics of spinal anesthesia using isobaric and hyperbaric ropivacaine (0.75%), in geriatric patients who underwent plastic surgical procedures in lower limbs. Study Design: Randomised double blind study. Methods: Sixty Geriatric patients were randomly assigned into two groups (I & H group). Group I patients were given spinal anaesthesia using 15mg of isobaric ropivacaine (0.75%), whereas group H patients were given hyperbaric ropivacaine (0.75%). The characteristics of intrathecal anesthesia, hemodynamic parameters, quality of anesthesia and muscle relaxation as well as duration of post-operative analgesia were compared. Results: In group H there was early onset of sensory block at T6 (group H 4.5 ± 2.3 vs. group I 6.4 ± 3.5 minutes; p = 0.015) and also early onset of grade 3 motor blockade (group H 5.10 ± 2.5 vs. group I 7.2 ± 4.4 minutes; p = 0.026); in addition as compared to group I, group H had shorter total duration of motor blockade (group H 127.3 ± 29.5 vs. group I 164.3 ± 35.2min; p < 0.0001), sensory blockade (group H 171.5 ± 28.1 vs. group I 207 ± 27.30 min., p < 0.0001) and duration of post-operative analgesia. Median maximum extent levels achieved, muscle relaxation and Quality of anesthesia were comparable in both groups. Conclusion: 15mg of (0.75%) hyperbaric ropivacaine provides similar, reliable and effective quality of spinal anesthesia with early onset and early recovery from sensory and motor blockade, when compared to 15mg of (0.75%) isobaric ropivacaine.