Recovery profile of intrathecal ropivacaine with or without fentanyl: A randomized double blind controlled trial in equivalent doses
Background: Since its inception, the subarachnoid block has remained the technique of choice for lower limb surgeries. However, nowadays, day surgery units are becoming popular which require anesthesia to be rapid, selective, and reversible with minimal hemodynamic alterations. Ropivacaine with its profile ideal for these types of surgeries is hereby compared with and without fentanyl as an adjuvant in patients undergoing spinal anesthesia for lower limb orthopedic surgery. Materials and Methods: A total of 60 American Society of Anesthesiologists Grade I/II patients posted for elective lower limb orthopedic surgeries were randomly given either 3 ml of 0.75% plain ropivacaine (22.5 mg) 0.5 ml normal saline or 3 ml of 0.75% plain ropivacaine (22.5 mg) 0.5 ml fentanyl (25 mg) The sensory and motor block characteristics, hemodynamic changes as well as any adverse effects were recorded. Results: Demographic data were similar between both groups. Onset to T 10 was faster (5.76 1.4) in Group RF compared to R (7.47 2.14; P 0.001) The median (range) maximum height in Group RF was T 2 (C 7 T 4 while in Group R was T 4 (T 1 T 6 Time to reach maximum height was shorter in Group RF. The onset of motor block was faster (8.43 1.80 min) in Group RF compared to Group R (12.27 1.78; P 0.001) Time to regression of sensory block to L 1 was longer in the Group RF than Group R (245.66 22.35 min vs. 187.16 17.053 min; P 0.001) Group RF (289.33 23.11) produced significantly longer duration of motor block compared to Group R (232.33 18.65; P 0.001) Duration of analgesia was significantly longer in Group RF than Group R (P 0.001) Conclusion: Both groups achieved adequate anesthesia and analgesia, however, ropivacaine with fentanyl produced a more rapid and prolonged sensory and motor blockade with minimal hemodynamic changes.