COMPARING 0.75% ROPIVACAINE VS 0.5% LEVOBUPIVACAINE FOR SPINAL BLOCK IN PCNL SURGERIES: A RANDOMIZED STUDY
DOI:
https://doi.org/10.22159/ijcpr.2025v17i6.7095Keywords:
Ropivacaine, Levobupivacaine, PCNL Surgeries, Subarachnoid blockAbstract
Objective: To evaluate the effectiveness, onset time, duration, and quality of both sensory and motor block, along with hemodynamic stability and postoperative pain relief, between 0.75% hyperbaric ropivacaine and 0.5% hyperbaric levobupivacaine during subarachnoid block in patients undergoing percutaneous nephrolithotomy (PCNL) procedures.Methods: This prospective, randomized, observer-blinded study compared the efficacy of 0.75% hyperbaric ropivacaine and 0.5% hyperbaric levobupivacaine for subarachnoid block in 150 patients undergoing percutaneous nephrolithotomy (PCNL) surgeries. Patients were randomly allocated into two groups: Group R (n=75) received 4 ml of 0.75% hyperbaric ropivacaine, and Group l (n=75) received 4 ml of 0.5% hyperbaric levobupivacaine intrathecally. The onset and duration of the sensory and motor blockade, analgesia, perioperative hemodynamic variations, side effects, and complications were evaluated.
Results: Group l showed significantly earlier onset times for sensory (7.96±1.13 min vs. 9.99±2.57 min; P<0.0001) and motor blocks (2±0.62 min vs. 2.74±0.9 min; P<0.0001) compared to Group R. The duration of sensory block (83.33±10.18 min vs. 59.57±8.15 min), analgesia (145.49±7.93 min vs. 127.8±6.22 min), and motor block (287.25±40.72 min vs. 199±24.38 min) were significantly longer in Group l (P<0.0001). The hemodynamic parameters remained stable in both groups, with no significant differences between the groups. The incidence of side effects was comparable between the groups.
Conclusion: In conclusion, 0.5% hyperbaric levobupivacaine provides a faster onset and prolonged duration of sensory and motor blockade, as well as extended analgesia, compared to 0.75% hyperbaric ropivacaine for subarachnoid block in PCNL surgeries, with a similar safety profile.
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