A COMPARATIVE STUDY OF 0.5% HYPERBARIC LEVOBUPIVACAINE AND 0.75% HYPERBARIC ROPIVACAINE FOR SPINALANAESTHESIA IN LOWER LIMB ORTHOPAEDIC SURGERIES

Introduction: Spinal anaesthesia is commonly used for lower limb surgeries, with hyperbaric bupivacaine as the preferred local anaesthetic. However, it carries a rare risk of fatal cardiotoxicity from accidental intravascular injection. Safer alternatives, such as ropivacaine and levobupivacaine, offer reduced cardiotoxicity. Aims & Objectives: Primary: Compare the efficacy of sensory and motor blockade with 0.5% hyperbaric levobupivacaine and 0.75% hyperbaric ropivacaine. Secondary: Assess hemodynamic changes, post-op analgesia requirement, and post-op nausea/vomiting. Methodology: Sixty ASA I–II patients undergoing lower limb surgery were randomized into two groups. Group L received 3ml hyperbaric levobupivacaine (0.5%), and Group R received 3ml hyperbaric ropivacaine (0.75%) intrathecally. Sensory block (pinprick test) onset, maximum height, 2-segment regression, and block duration were recorded. Motor block onset and recovery were assessed using the Modified Bromage scale. HR, BP, and SpO2 were monitored for adverse effects like hypotension, bradycardia, nausea, and vomiting. Results: Both groups showed similar sensory and motor block onset and 2-segment regression times. Levobupivacaine had longer sensory (235.67 min) and motor block durations (183.33 min) compared to ropivacaine (206.23 min, 157 min), with significant differences (p=0.002, p=0.001). Adverse effects were comparable. Conclusion: Levobupivacaine offers a longer sensory and motor block, while both drugs provide effective spinal anaesthesia for lower limb surgeries.