A randomised comparative double blinded study of two different doses of intrathecal 0.75% isobaric ropivacaine and fentanyl in caesarean sections.

Background and Aim: Subarachnoid block is the technique of choice in Caesarean sections for which 0.5% hyperbaric solution of Bupivacaine is the most commonly used local anaesthetic agent. However, newer local anaesthetics like Ropivacaine which produces relatively lower motor block and better sensory-motor differentiation with haemodynamic stability can also be used. The present study was aimed to compare two different doses of isobaric ropivacaine (0.75%) with fentanyl as adjuvant intrathecally, in patients undergoing elective caesarean section in terms of mean duration of postoperative analgesia, block characteristics, adverse effects and patient’s satisfaction. Materials and Methods: Sixty term parturients aged 18-45 years with ASA physical status II undergoing elective Caesarean section were included and randomised into two groups, Group A and Group B; with 30 patients in each group.In Group A, 2.5ml of Inj. 0.75% Isobaric Ropivacaine-1.8ml (13.5mg) 0.5ml Fentanyl (25mcg) 0.2ml 0.9% NS was injected intrathecally and in Group B it was 2.5ml of Inj 0.75% Isobaric Ropivacaine-2.0ml (15mg) 0.5ml Fentanyl (25mcg).we assessed the onset and duration of motor and sensory blockade along with the duration of post operative analgesia. Haemodynamic variables were also compared and patients were observed for any side effects or complications related to the drug and technique. Surgeon’s and patient’s satisfaction was also noted. Results: The mean time to onset of both sensory and motor block was lesser in group B as compared to group A. Group B had longer mean duration of sensory and motor block. The mean time to first rescue analgesic was lesser in group A as compared to group B (p-value <0.001). Conclusion: Low dose isobaric ropivacaine with fentanyl provides dense sensory block with early recovery of motor blockade and better haemodynamic stability.