Comparison of Levobupivacaine and Ropivacaine in Cervical epidural anaesthesia for thyroid surgery

Abstract

Thyroid surgeries are conventionally performed under general anaesthesia (GA). With the rising concern for GA-related implications on cardiorespiratory, metabolic and immune status of the patient, a preference for regional anaesthetic techniques has increased worldwide. Epidural anaesthesia is a ubiquitous technique in regional anaesthesia. While the earlier trials have widely focused on lumbar or thoracic epidurals, the cervical approach has been an upcoming technique since the past few years and has attracted investigators to explore its viability for various surgeries.

The study was conducted on 80 patients and patients were divided into 2 groups of 40 patients each.

Group L receiving 10 ml Levobupivacaine (0.5%) and Group R receiving 10 ml Ropivacaine (0.5%) for Cervical Epidural Anaesthesia.

Both the groups were compared in terms of mean systolic blood pressure, mean diastolic blood pressure, MAP, and there was no significant difference at preoperative period, 30 min. after cervical epidural anaesthesia and at the end of surgery (p>0.05) (although mean SBP, mean DBP and MAP decreases after CEA in both groups).But when both the groups were compared in terms of mean onset time of sensory and motor blockade, there was significant difference (p<0.05).

We concluded that the surgeries on thyroid gland can safely be performed under CEA using any of the two formulations of local anaesthetics chosen for our study. In an equal dose (10 ml) Levobupivacaine (0.5%) has a faster onset (sensory and motor block) and longer duration (motor block and analgesia) as compared to Ropivacaine (0.5%). Due to long duration of motor block and analgesia of Levobupivacaine can be used as replacement for other local anaesthetic agent.