Haemodynamic Comparison of Intrathecal Hyperbaric 0.5% Bupivacaine 2ml(10mg) with Isobaric 0.75% Ropivacaine 2ml(15mg) with Fentanyl 20μg as Adjuvent in Geriatric Patients undergoing Major Lower Limb Orthopedic Surgery

Aims and Objectives: Spinal anaesthesia is the most commonly used method of anaesthesia and analgesia in lower limb surgeries. In elderly patients spinal anaesthesia causes more sympatholysis and hemodynamic disturbances than young patients. So low dose of local anaesthetic is preferred which may occasionally cause failure of spinal anaesthesia .Therefore, different adjuvents are added to achieve desired level of anaesthesia to local anaesthetic. The aim of this study is to compare intraoperative hemodynamic changes associated with intrathecal use of hyperbaric 0.5% bupivacaine 2ml(10mg) and Isobaric .75% ropivacaine 2ml (15 mg) both with fentanyl 20μg in geriatric patients undergoing major lower limb orthopaedic surgeries. Method: Sixty geriatric patients undergoing major orthopaedic surgeries were divided into two groups of thirty each. First group (Group R) was given spinal anaesthesia with isobaric .75% ropivacaine 2ml (15mg) and fentanyl 20μg and second group (Group B) was given spinal anaesthesia with .5% bupivacaine 2ml (10mg) and 20μg fentanyl.Baseline and intraoperative hemodynamic parameters and onset and duration of sensory and motor blockade were evaluated. Unpaired Student’s t-test and analysis of variance were applied for quantitative data and Chi-square test for qualitative data. Results: Incidence of hypotension was greater in bupivacaine group than ropivacaine group (p value<.05).Duration of sensory and motor blockade was less in ropivacaine group than bupivacaine group (p value<.05). Conclusion: Low dose of ropivacaine and fentanyl provides better hemodynamic stability and shorter duration of motor block so it is a better choice of anaesthesia in surgeries requiring early ambulation in geriatric patients.