Abstract

Background: Local anesthetic selection for spinal anesthesia significantly influences block characteristics, safety profile, and patient outcomes. Ropivacaine, with its reduced cardiotoxicity and neurotoxicity compared to bupivacaine, has emerged as an attractive alternative for neuraxial anesthesia.
Objective: To compare the efficacy, safety, and block characteristics of hyperbaric ropivacaine 0.75% versus hyperbaric bupivacaine 0.5% in patients undergoing spinal anesthesia for lower abdominal and lower limb surgeries.
Methods: This prospective, randomized, double-blind study included 120 patients (ASA I-II) scheduled for elective surgery under spinal anesthesia. Patients were randomly allocated into two groups: Group R (n=60) received 15 mg of 0.75% hyperbaric ropivacaine, and Group B (n=60) received 15 mg of 0.5% hyperbaric bupivacaine. Primary outcomes included onset and duration of sensory and motor blockade. Secondary outcomes encompassed hemodynamic parameters, recovery characteristics, and adverse effects.
Results: Sensory block onset was faster in Group B (4.2±1.1 min) compared to Group R (5.8±1.4 min, p<0.001). However, Group R demonstrated shorter duration of motor blockade (168±32 min vs 198±38 min, p<0.001) with earlier mobilization. Duration of sensory blockade was comparable between groups (Group R: 185±28 min vs Group B: 192±31 min, p=0.174). Hemodynamic stability was superior in Group R with lower incidence of hypotension (18.3% vs 35%, p<0.05). Patient satisfaction scores were higher in Group R (8.4±1.2 vs 7.6±1.4, p<0.01).
Conclusion: Both hyperbaric ropivacaine 0.75% and hyperbaric bupivacaine 0.5% provide effective spinal anesthesia. Ropivacaine offers advantages of better hemodynamic stability, shorter motor blockade duration, and higher patient satisfaction, making it a suitable alternative to bupivacaine for spinal anesthesia.