ASSESSING THE EFFICACY AND SAFETY OF BUPIVACAINE VERSUS ROPIVACAINE IN FIELD BLOCK ANESTHESIA FOR UNILATERAL INGUINAL HERNIA REPAIR
Creators: name: Dr. Raja Ganapathi
name: Dr. Vinith Kumar
name: Dr. Prabhu Thilaak
name: Dr. Rajesh
name: Dr. R Brindha
Publisher: name: Zenodo
Year: 2024
Subjects: Inguinal Hernia Repair, Field Block Anesthesia, Bupivacaine, Ropivacaine Postoperative Pain Relief, Hemodynamic Stability.

description: Abstract 

Background: Inguinal hernia repair is a common surgical procedure performed globally. Various techniques are employed for this surgery, including open and laparoscopic approaches. Anesthesia plays a crucial role in the success of the surgery and the comfort of the patient. Field block anesthesia has gained popularity for inguinal hernia repair due to its safety, simplicity, effectiveness, cost-effectiveness, and suitability for day care surgeries and geriatric patients. Bupivacaine and Ropivacaine are widely used local anesthetics for field block anesthesia. Both drugs have unique pharmacological profiles, with Bupivacaine known for its potent and long-lasting effects and Ropivacaine for its safer cardiovascular profile and differential sensory and motor block. The choice of anesthetic can significantly impact the patient's postoperative experience, including pain relief, recovery time, and overall satisfaction. Aim and Objectives: The aim of this study is to compare the efficacy and safety of 0.5% Bupivacaine and 0.75% Ropivacaine in field block anesthesia for unilateral inguinal hernia repair. The objectives include assessing and comparing the onset of analgesia, adequacy of block, duration of postoperative pain relief, side effects, and hemodynamic changes between the two groups. Materials and Methods: This prospective, double-blinded study included 60 male patients aged 20-80 years undergoing elective unilateral inguinal hernia repair under field block anesthesia. Patients were randomly assigned to two groups: Group B (Bupivacaine) and Group R (Ropivacaine). The field block was performed using a standardized technique, with the onset of block assessed by pinprick test, adequacy of block judged by subjective pain perception and surgeon's verdict, and postoperative pain relief measured by the time to first analgesic requirement. Side effects and hemodynamic parameters were monitored and recorded throughout the study. Results: The onset of block was significantly faster in the Bupivacaine group, with a mean onset time of 5.7 minutes, compared to 11.3 minutes in the Ropivacaine group. The adequacy of the block was similar in both groups, with 63.3% of patients in the Bupivacaine group and 56.7% in the Ropivacaine group reporting no need for supplemental analgesia. The duration of postoperative pain relief was longer in the Ropivacaine group, with a mean time of 6 hours, compared to 4.5 hours in the Bupivacaine group. Side effects were minimal and comparable between the two groups. Hemodynamic parameters remained stable throughout the study in both groups. Discussion: The study demonstrated that while Bupivacaine provides a quicker onset of analgesia, Ropivacaine offers a longer duration of postoperative pain relief. Both anesthetics were effective in providing adequate block for inguinal hernia repair, with minimal side effects and stable hemodynamics. The choice between Bupivacaine and Ropivacaine should be based on the specific needs of the patient and the surgery, considering the balance between onset and duration of analgesia. Conclusion: Both 0.5% Bupivacaine and 0.75% Ropivacaine are effective and safe options for field block anesthesia in unilateral inguinal hernia repair. Bupivacaine is preferable for its rapid onset of action, while Ropivacaine is advantageous for its longer duration of postoperative pain relief and safer cardiovascular profile. The choice of anesthetic should be tailored to the individual patient's requirements and the surgical context.