Srinivasan, R (2013) A Study of clinical effects of Intra Thecal Ropivacaine and Ropivacaine with Dexmedetomidine in Inguinal Hernia Cases: A Study of 60 cases. Masters thesis, Tirunelveli Medical College, Tirunelveli.
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Abstract
INTRODUCTION: It is always our first priority to select regional anesthesia in almost all procedures as much as possible. The subarachnoid block (or intra thecal) and epidural anaesthesia is a wonderful method of giving anaesthesia in lower abdominal and lower limb surgeries. With the help of lignocaine and bupivacaine we are using spinal blockade for long time since its invention. Lignocaine and Bupivacaine are the drugs used for long time. In this setting one of the newer drug Ropivacaine has emerged and which is available as only isobaric solution. It is used mainly for epidural, nerve plexus blocks. Now only it is available as 0.75% solution and most of us are not using it very much for subarachnoid block. That’s why Ropivacaine was chosen as 0.75% intra thecal for my study. Dexmedetomidine is one of the newer drug very much used for sedation and to potentiate the effect of local anaesthetics. AIM OF STUDY: To compare the clinical effects of intra thecal ropivacaine and ropivacaine with dexmedetomidine with respect to 1. Onset of sensory and motor blockade, 2. Hemodynamic stability, 3. Duration of sensory and motor blockade, 4. Associated complications. MATERIALS AND METHODS: Study design: This was a randomized, prospective double blind comparative clinical study. Randomization: Simple randomized sampling was done by computer generated random numbers. Sample size: Sixty patients were studied. Inclusion criteria: 1. Age between 30 – 60 years and only male cases. 2. ASA I & II cases. 3. Weight 40 – 65 kg. 4. Elective surgeries (Inguinal hernioplasty). Exclusion criteria: 1. Patient refusal, 2. Known allergy, 3. Coagulopathy, 4. Patient on β blockers, 5. Patient on long term analgesic therapy, 6. Patient on drugs which are known to interact with study drugs. Statistical Analysis: The two groups were matched according to their base line characteristics of continuous variables by Students’ independent ‘t’ test. And the categorical variables between two group were matched by χ2 (Chi square) test. The on set sensory block, motor block and rescue of analgesia and motor block duration were compared between two groups. The analysis and interpretations were performed by IBM SPSS statistics 20. The P- values lessthan 0.05 (P< 0.05) were defined as statistically significant in two tailed test. SUMMARY: It was found that intrathecal ropivacaine in this study produces T7 – T8 level of sensory blockade with adequate motor blockade for hernia surgery and patients were hemodynamically stable. With group 2 patients early onset of sensory and motor blockade and delayed recovery from sensory blockade and motor blockade noted with the risk of getting bradycardia and hypotention. But patients were more comfortable (free of anxiety) in this group 2 than group 1. Only one patient developed PDPH which was relieved by intra venous fluids. CONCLUSION: Ropivacaine is a newer ideal, safe anaesthetic of choice for intra thecal use in inguinal hernia surgery cases, (ASA I & II) and by adding dexmedetomidine we get prolongation of analgesia.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Intra Thecal Ropivacaine ; Ropivacaine ; Dexmedetomidine ; Inguinal Hernia Cases ; Study of 60 cases. |
| Subjects: | MEDICAL > Anaesthesiology |
| Depositing User: | Subramani R |
| Date Deposited: | 30 Apr 2018 02:56 |
| Last Modified: | 01 May 2018 07:56 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/7350 |
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