• K Kulkarni, I J Namazi, S Deshpande, and R Goel.
• Department of Anaesthesia, D.Y. Patil Medical College, Kolhapur, Maharashtra, India.
• Kathmandu Univ Med J (KUMJ). 2013 Apr 1;11(42):126-31.

BackgroundCervical epidural anaesthesia (CEA) using local anesthetics (LA) is a well established technique for the surgeries in the neck, chest and upper arms. Recently ropivacaine is introduced with better safety profile.ObjectivesThe aim was to observe the safety of Cervical epidural anaesthesia as an anaesthetic technique and to compare the efficacy of epidural 0.25% bupivacaine with 0.375% ropivacaine for radical mastectomies.MethodsA double blind study was conducted on 40 ASA grade I / II females who received CEA with 10 ml of 0.25% of bupivacaine +25μg of fentanyl in group B (n=20) and 10 ml of 0.375% of ropivacaine +25μg of fentanyl in group R (n=20) epidurally. Assessment of the block, vital monitoring and complications noted.ResultsNo significant differences observed in the onset of sensory block (5.05 min and 5.4 min in group B and R respectively, P>0.05).The mean motor blockade score, time to achieve complete blockade and time to grade I motor recovery was significantly longer in group B (2.3, 22.5 and 79.5 minutes respectively) as compared to group R (1.5, 18.3 and 66.3 minutes respectively, P<0.05). Respiratory distress developed in two patients of group B that required general anaesthesia (GA) with intubation.ConclusionUse of 0.37% ropivacaine is safer than 0.25% bupivacaine for CEA for radical mastectomy. It provides good surgical anaesthesia with lesser degree of motor blockade and the respiratory effects.

31 keywords...

hide…