A Prospective Randomised Controlled Study Comparing the Efficacy of Hyperbaric Levo Bupivacaine with Nalbuphine Versus Hyperbaric Ropivacaine with Nalbuphine in Subarachnoid Block for Lower Limb Orthopaedic Surgeries

Abstract

Background: Spinal anaesthesia is the most preferred regional anesthesia technique as it is easy to perform, economical and produces rapid onset of anaesthesia and complete muscle relaxation. Present study aims to evaluate the effects of intrathecal 0.5% hyperbaric levobupivacaine combined with nalbuphine versus intrathecal 0.75% hyperbaric ropivacaine combined with nalbuphine, in patients undergoing Orthopedic surgeries of the lower limbs. Materials and Methods: A total of 60 patients, categorized into ASA grading I and II, were randomly allocated into Group LB and Group R of 30 each. Group LB received 3ml of 0.5% hyperbaric levobupivacaine + 0.8 mg nalbuphine while Group R received 3ml of 0.75% hyperbaric ropivacaine + 0.8 mg nalbuphine. Statistical analysis was carried out using SPSS Version 26.0 and p < 0.05 was considered to be significant. Results: The study revealed no significant difference in age, sex, weight between the two groups. The mean time to onset of sensory block and motor block was significantly faster (2.12 vs 2.89 mins, p<0.01; 2.57 vs 3.28 mins, p<0.01) and duration was significantly longer (412.2 vs 346.8 mins, p<0.01; 317.4 vs 247.2 mins, p<0.01) in Group LB compared to R Group. There is no significant difference regarding side effects like hypo-tension, bradycardia, PONV, respiratory depression in both the groups. Conclusion: Hyperbaric levobupivacaine with nalbuphine provides reliable spinal anaesthesia of longer duration than hyperbaric ropivacaine with nalbuphine and can provide a safe alternative to ropivacaine for lower limb orthopedic surgeries.