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OP19 Comparison of block characteristics and outcomes of hyperbaric versus isobaric ropivacaine in patients undergoing modified radical mastectomy under segmental thoracic spinal anaesthesia: an exploratory double-blinded randomized control trial
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OP19 Comparison of block characteristics and outcomes of hyperbaric versus isobaric ropivacaine in patients undergoing modified radical mastectomy under segmental thoracic spinal anaesthesia: an exploratory double-blinded randomized control trial
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OP19 Comparison of block characteristics and outcomes of hyperbaric versus isobaric ropivacaine in patients undergoing modified radical mastectomy under segmental thoracic spinal anaesthesia: an exploratory double-blinded randomized control trial
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Journal Article
OP19 Comparison of block characteristics and outcomes of hyperbaric versus isobaric ropivacaine in patients undergoing modified radical mastectomy under segmental thoracic spinal anaesthesia: an exploratory double-blinded randomized control trial
2025
Overview
Background and AimsThoracic spinal anaesthesia (TSA) is emerging as an alternative to general anaesthesia for modified radical mastectomy (MRM) for carcinoma breast due to its favorable recovery profile. The present study aims to evaluate block characteristics and outcomes of isobaric and hyperbaric ropivacaine in TSA for the sameMethodsSixty patients scheduled for unilateral MRM were randomly allocated to equally to; Group I: (0.75% isobaric ropivacaine-1 mL) and Group H: (0.75% hyperbaric ropivacaine -1 mL) along with fentanyl (25 μg) in both groups for TSA at (T4-T5) level, administered in lateral position and turned to supine immediately. The primary objective of the study was to evaluate the block onset time at T2 dermatome and secondary objectives included peak sensory loss at 10 min, intraoperative cardio-respiratory changes and post operative pain scores. Data were compared using the two-sided Student t-test, Mann-Whitney and Chi-square tests.ResultsTime of onset of sensory block (in min) at T2 level (3.00 ± 0.00 versus 3.40 ± 1.04, p = 0.04) and peak sensory loss at 10 min (C5 sensory level at 10 min, 93% versus 60%, p <0.001) was faster with Group H. Intraoperative hypotension occurred in 63% in group I, while only 16% in group H. 10% of patients in group I had bradycardia, while none of in group H. Intraoperative apnea occurred in 23% in group I while none of the patients in group H. Postoperative pain scores were comparable till 24 h.ConclusionsThe hyperbaric ropivacaine (0.75%) provides faster onset of sensory blockade, better cardio-respiratory profile compared to isobaric ropivacaine (0.75%) in patients undergoing unilateral modified mastectomy for carcinoma breast under thoracic spinal anaesthesia.
Publisher
BMJ Publishing Group LTD
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