A DOUBLE-BLIND RANDOMIZED CONTROL TRIAL TO COMPARE POSTOPERATIVE ANALGESIA WITH EPIDURAL BUPIVACAINE 0.25% AND ROPIVACAINE 0.2% IN LUMBAR SPINE SURGERY

Background: Postoperative pain after spinal surgery delays mobility and discharge from hospital. Bupivacaine and ropivacaine have similar nerve-blocking effects but differ in their impact on motor function. The study aimed to compare these two drugs for epidural analgesia. Methods: After ethical permission and informed consent, a prospective double blind randomized study was conducted at tertiary care hospital, from June 2022 to January 2024 in ASA Grade I or II patients aged 18 and older undergoing lumbar spine surgery under general anaesthesia. Eighty patients were randomly assigned, 40 in each group, to receive either bupivacaine (0.25%) or ropivacaine (0.2%) via epidural infusion with fentanyl. The patients were evaluated for VAS score, motor blockade at pre decided time points (0, 8, 16, 24, 36, 48 hours) and time taken to perform specific manoeuvres. Both the groups were comparable with respect to demographic data and ASA grading. The vi Results: sual analog scale (VAS) scores were comparable at rest and during coughing between the bupivacaine and ropivacaine groups at 0, 8, and 36 hours, but ropivacaine provided significantly better pain relief at 16 and 24 hours. The VAS scores at mobilization showed no significant differences between Bupivacaine and Ropivacaine at 0, 8 hours. However, Ropivacaine showed better pain relief at 16, 24, 36 and 48hours. The motor block assessment showed no significant differences between Bupivacaine and Ropivacaine at 0, 8, 24 and 36 hours. However, at 16 hours with Ropivacaine showed less motor blockade. Ropivacaine was associated with better functional outcomes in terms of maneuvers like turning, standing in front of the bed, walking, and using the toilet, compared to Bupivacaine. Conclusion: For postoperative pain, ropivacaine was more effective than bupivacaine, providing better VAS scores, less motor blockade, and earlier mobility