EFFICACY OF ROPIVACAINE VERSUS BUPIVACAINE FOR POSTOPERATIVE ANALGESIA BY WOUND INSTILLATION THROUGH SURGICAL DRAIN IN MODIFIED RADICAL MASTECTOMY
Dr. Manju Lata Shakya and Dr. Subhash Kumar Agrawal*
ABSTRACT
Introduction: Local anesthetics used in forms of infiltration and instillation in breast surgeries at surgical site to relieve postoperative pain. So, in this study we compared the efficacy of Ropivacaine and Bupivacaine instillation through chest and axillary drains in modified radical mastectomy. Study design: A prospective type of study. Material and Method: In this prospective randomized controlled study, 90 patients aged 45–60 years, ASA I and II, were divided into three groups. Surgical procedure was done under general anaesthesia. At the end of the surgical procedure, axillary and chest wall drains were placed before closure of surgical incision. Group R received 0.2% (0.5ml/kg) Ropivacaine, Group B received 0.25 %( 0.5ml/kg) Bupivacaine and Group S received 0.9% (0.5ml/kg) Normal Saline, through axillary and chest drain. Results and Conclusion: There was no significant difference in the cumulative analgesic requirement and the number of analgesic demands between the Group R and Group B. The mean duration of analgesia in the Bupivacine group was 14.8 hr, 12.9 in Ropivacaine group and 5.7 h in saline group. Wound instillations with Ropivacaine and Bupivacaine provide more effective and longer duration of analgesia but Ropivacaine also has less cardiovascular and central nervous system side effects.
Keywords: Ropivacaine, Bupivacaine, Mastectomy, Postoperative pain.
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