Comparative evaluation of hyperbaric ropivacaine with hyperbaric bupivacaine for spinal anesthesia in elective gynecological surgeries

Abstract EN

Background : Hyperbaric ropivacaine provides adequate sensory and motor block for short duration surgical procedures, safe hemodynamic profi le, rapid recovery, early ambulation, and less side effects.

Aim and objective The aim of this study was to evaluate the clinical effi cacy and safety of subarachnoid block with 0.5% hyperbaric ropivacaine compared with 0.5% hyperbaric bupivacaine in elective gynecological surgeries.

Methods Fifty female patients of ASA physical status I and II were randomly selected and divided into two groups: group R and group B.

Group R was given 3 ml of 0.5% hyperbaric ropivacaine (15 mg) and group B was given 3 ml of 0.5% hyperbaric bupivacaine (15 mg) during subarachnoid block.

Preoperative and intraoperative hemodynamic variables such as heart rate, blood pressure, and SpO2 were recorded.

Sensory and motor block were also assessed at regular intervals.

Results The mean time to achieve the highest level of sensory block was 13.1 min in group R and 12.2 min in group B (P < 0.05).

Maximum sensory level was T8 and T7 in group R and group B, respectively (P < 0.05).

The onset time for motor block was 6.16 min with bupivacaine versus 9.04 min with ropivacaine (P < 0.05).

The duration of motor block (grade I) was longer (162.8 min) with bupivacaine than (131.7 min) with ropivacaine (P < 0.05).

Despite adequate hydration, 40% of patients developed hypotension in group B compared with 16% in group R.

Conclusion Hyperbaric ropivacaine has lower level of cephalad spread of sensory block, takes more time for maximum spread of analgesia, has early regression of sensory block to L5, has longer onset time for motor block, shorter duration of motor block, and causes less hypotension and other side effects compared with hyperbaric bupivacaine.