Comparison of epidural Ropivacaine 0.75% and Ropivacaine 0.75% Plus Buprenorphine (0.5 ml) for total knee replacement surgery

Aim and Objectives: To assess the comparison between ropivacaine and combination of ropivacaine with buprenorphine in terms of onset and duration of analgesia, cardiorespiratory effects, side effects and post-operative analgesia. Methods: Total 60 adult patients of either sex, ASA grade I - II, schedule for total knee replacement surgery were enrolled in the study and randomized into two groups. Group R: received 14.5ml of 0.75% plain Ropivacaine + 0.5ml Normal saline (NS) making volume 15ml. Group RB: received 14.5ml of 0.75% plain Ropivacaine + Buprenorphine 150 mics (0.5ml) making volume 15ml. Onset of sensory-motor block, hemodynamic variables (HR, SBP, DPB, MAP, RR), duration of analgesia were recorded. Results: The onset of sensory blockade was earlier in group R as compared to in group RB. The motor onset time was similar in both the groups. The mean hemodynamic parameters were comparable in both the groups. Duration of analgesia was prolonged in group RB as compared to group R. Group RB had more incidences of post-op vomiting (36.67%) and pruritus (3.3%) as compared to group R. Conclusion: The addition of buprenorphine to epidural ropivacaine is a well tolerated, effective method for epidural anesthesia in patients undergoing unilateral total knee replacement surgery.