Comparision of analgesic efficacy of ropivacaine and bupivacaine in rectus sheath block for midline abdominal surgeries

Background: In the modern setting the rectus sheath block (RSB) has been found effective in decreasingopioid requirement after both diagnostic and interventional laparoscopy and laparotomy. Efficacy of rectussheath block (RSB) using ropivacaine versus bupivacaine for acute postoperative pain relief is not muchinvestigated.Material and Methods: 90 patients undergoing elective midline abdominal surgeries under generalanaesthesia were randomly divided into three groups of 30 patients each, destined to receive bilateral rectussheath block using 15 ml on each side (total 30 ml) of 0.25% ropivacaine in Group R, 0.25% bupivacaine inGroup B or normal saline in Group C. Three groups were compared regarding time to first rescue analgesicfrom time of RSB (duration of analgesia), total rescue analgesic (tramadol) consumption in first 10 hours,visual analogue score (VAS), satisfaction score and adverse effects.Result: Mean duration of analgesia was significantly longer in group R (5.780.93h) than group B(3.63+0.90 h) and group C (2.37+0.44 h), p group B > group C). This trend wasobserved in both hernia repair and laparotomy. Rescue analgesic consumption in terms of number of doseswas significantly less in Group R (30) than in Group B (38) than in Group C (59), psignificantly less and patient satisfaction was significantly better in Group R than in Group B than in GroupC, (pConclusion: Bilateral single shot rectus sheath block (RSB) using isobaric ropivacaine (0.25%) orbupivacaine (0.25%) is a safe and effective method of providing postoperative analgesia to patientsundergoing midline abdominal surgeries. The lower cardio toxicity profile with the excellent prolongedpostoperative analgesia makes ropivacaine an excellent choice for the RSB as compared to bupivacaine.Keywords: Rectus sheath block, Ropivacaine, Bupivacaine, Laparotomies.