TY - JOUR AU - Kulkarni, K AU - Namazi, IJ AU - Deshpande, S AU - Goel, R PY - 2015/05/02 Y2 - 2024/03/29 TI - Cervical Epidural Anaesthesia with Ropivacaine for Modified Radical Mastectomy JF - Kathmandu University Medical Journal JA - Kathmandu Univ. Med. J. VL - 11 IS - 2 SE - Original Articles DO - 10.3126/kumj.v11i2.12487 UR - https://www.nepjol.info/index.php/KUMJ/article/view/12487 SP - 126-131 AB - <p class="Pa4"><strong>Background </strong></p> <p class="Pa4">Cervical 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.</p> <p class="Pa4"><strong>Objectives </strong></p> <p class="Pa4">The 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.</p> <p class="Pa4"><strong>Methods </strong></p> <p class="Pa4">A double blind study was conducted on 40 ASA grade I / II females who received CEA with 10 ml of 0.25% of bupivacaine +25&mu;g of fentanyl in group B (n=20) and 10 ml of 0.375% of ropivacaine +25&mu;g of fentanyl in group R (n=20) epidurally. Assessment of the block, vital monitoring and complications noted.</p> <p class="Pa4"><strong>Results </strong></p> <p class="Pa4">No significant differences observed in the onset of sensory block (5.05min and 5.4min in group B and R respectively, P&gt;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&lt;0.05). Respiratory distress developed in two patients of group B that required general anaesthesia (GA) with intubation.</p> <p class="Pa4"><strong>Conclusion </strong></p> <p class="Pa10">Use 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.</p> <p>DOI: <a href="http://dx.doi.org/10.3126/kumj.v11i2.12487">http://dx.doi.org/10.3126/kumj.v11i2.12487</a></p> <p>Kathmandu University Medical Journal Vol.11(2) 2013: 126-131</p> ER -