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Comparative Evaluation of 0.5% Ropivacaine and 0.5% Bupivacaine for Day Case Inguinal Herniorrhaphy in a Nigerian Tertiary Health Institution.


BO Bolaji
IF Yusuf
GA Rahman
SA Kuranga
OO Oyedepo

Abstract

Background: Day case inguinal herniorrhaphy is a common surgical procedure performed in our environment with lidocaine used for field block. The study was aimed at comparing 0.5% ropivacaine and 0.5% bupivacaine for the field block, determine their effectiveness and safety in our environment.
Methods: In a double-blind randomized study, 52 ASA physical status I-II patients (age >18yrs) scheduled for field block for day case inguinal herniorrhaphy were assigned to two study groups to receive 0.5% ropivacaine 25ml (n = 26) or 0.5% bupivacaine 25ml (n = 26). Onset of analgesia, adequacy of block, duration of postoperative pain relief and pain score at first requirement of analgesic were recorded.
Results: One patient in the bupivacaine group did not complete the study. Patient demographic characteristics and surgical times were similar in the two groups. Mean onset time of anaesthesia was shorter in the bupivacaine group than the ropivacaine group (5.37± 0.50 min vs 5.48 ± 0.45 min) although this was not significant (P = 0.44). Adequacy of block was similar in the two groups (P = 0.55). Postoperative pain relief was significantly longer for the ropivacaine group 6.83 ± 0.57hr than for the bupivacaine group 6.32 ± 0.35 hr (P = 0.0004, unpaired t-test). Mean pain score at the first requirement for analgesic was lower in the ropivacaine group 1.38 ± 0.49 than the bupivacaine group (1.56 ± 0.51), but this was not significant (P = 0.22). Few untoward effects of nausea and dizziness were observed in this study.
Conclusion: Ropivacaine and bupivacaine have comparable onset of actions and adequacy of anaesthesia when used for day case inguinal herniorrhaphy and are safe.

Key words: Blood glucose, fasting, elective surgery.

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