Comparative study of ropivacaine (0.5%) versus levobupivacaine (0.5%) as regional anesthesia in gynecological surgeries: A tertiary care hospital based study at Eastern India

Abstract

Introduction: Most women experience moderate to severe pain during labor and delivery, often requiring some form of pharmacologic analgesia. The lack of proper psychological preparation combined with fear and anxiety can greatly enhance the patient’s sensitivity to pain and further add to the discomfort during labor and delivery. However, skillfully conducted obstetric analgesia, in addition to relieving pain and anxiety, may benefit the mother in many other ways. The aim of this prospective, randomized, double-blind study was to compare the block induced by ropivacaine (0.5%) plain and levobupivacaine (0.5%) plain in gynecological surgeries at the recommended dose range. These concentrations have provided equivalent block after epidural analgesia. Material and methods: This randomized, prospective, double blind study was conducted at a tertiary care hospital in Department of Anesthesia and Obstetrics & Gynaecology, Haldia, West Bengal between Jan 2019-December 2019. Fifty patients who were posted for gynecological surgeries were enrolled and randomly divided into two groups: Group R received 3.5 ml (17.5 mg) 0.5% ropivacaine plain and Group L received 3.5 ml (17.5 mg) 0.5% levobupivacaine plain. The onset and duration of sensory and motor block and any undesirable side effects were noted. Results: The mean sensory block onset time in levobupivacaine group was 6.23 ± 1.13 min, while it was 7.89 ± 2.74 min in ropivacaine group. The mean sensory onset time was higher in ropivacaine as compared to levobupivacaine group (P = 0.0073). The mean duration of sensory block in levobupivacaine group was 265.87 ± 79.67 min, while it was 239.89 ± 61.18 min in ropivacaine group. The mean duration of sensory block was higher in levobupivacaine group in comparison to ropivacaine group (P = 0.2021, NS). The mean motor block onset in levobupivacaine group was 5.29 ± 2.23 min, while it was 6.78 ± 2.67 min in ropivacaine group. The mean motor onset time was higher in ropivacaine group in comparison to levobupivacaine group (P = 0.0373). The mean duration of motor block in levobupivacaine group was 248.33 ± 78.18 min, while it was 209.29 ± 53.16 min in ropivacaine group. The mean duration of motor block was higher in levobupivacaine group in comparison to ropivacaine group (P = 0.0373). Conclusion: The mean duration of sensory block was higher in levobupivacaine group in comparison to ropivacaine group (P = 0.2021, NS). The mean motor onset time was higher in ropivacaine group in comparison to levobupivacaine group (P = 0.0373). The mean duration of motor block was higher in levobupivacaine group in comparison to ropivacaine group (P = 0.0373).