A Randomized Double Blind Controlled Interventional Study of Intrathecal Ropivacaine (0.75%) Alone or Ropivacaine (0.75%) with Fentanyl as Adjuvant in Lower Limb Surgeries under Spinal Anaesthesia

BACKGROUND AND AIM: Postoperative pain is a well known morbidity and causes distress to the patients. Aim of this study was to assess the clinical efficacy of 3 ml of 0.75 % ropivacaine alone versus ropivacaine with 25mcg fentanyl in spinal anaesthesia for lower limb surgeries in terms of duration of analgesia, sensory and motor block characteristics, haemodynamic profile and complications. METHODS: This study was conducted in a randomized double blind fashion on 80 ASA physical status I-II patients scheduled for lower limb surgeries. They were randomized into two groups of 40 patients in each group using sealed envelope technique. GROUP A: Patients received 3 ml 0.75 % Isobaric Ropivacaine hydrochloride GROUP B: Patients received 3ml 0.75 % Isobaric Ropivacaine with 25µg Fentanyl hydrochloride. We evaluated whether addition of fentanyl to intrathecal ropivacaine could make a significant effect on onset and duration of analgesia, sensory and motor block. RESULTS: Isobaric Ropivacaine 3 ml 0.75 % alone and with fentanyl (25mcg) in spinal anaesthesia produced effective sensory-motor blockade of sufficient duration with stable hemodynamic profile to accomplish lower limb surgeries. Addition of fentanyl to Isobaric 0.75 % Ropivacaine prolonged the duration of analgesia and sensory block, without affecting sympathetic or motor block characteristics. CONCLUSION: Addition of fentanyl to ropivacaine prolongs the duration of sensory block with stable hemodynamics and minimal side effects.