A Comparative Study of Intrathecal 0.5% Hyperbaric Bupivacaine and Intrathecal 0.75% Hyperbaric Ropivacaine in Elective Lower Segment Cesarean Section

Abstract

Aim: To evaluate and compare the efficacy and safety of intrathecal 0.5% hyperbaric bupivacaine and intrathecal 0.75% hyperbaric ropivacaine in patients posted for elective lower segment cesarean section (LSCS) under spinal anesthesia. Objective: The objective of this study was to compare intrathecal 0.5% hyperbaric bupivacaine and intrathecal 0.75% hyperbaric ropivacaine in patients posted for elective LSCS under spinal anesthesia with respect to the onset and duration of sensory block, onset and duration of motor block, hemodynamic parameters, and adverse effects. Material and Methods: Patients with ASA physical status II of age ranging from 18 to 35 years were included in the study. Patients were randomized into two groups using a sealed envelope technique. A) Group B (n = 30); 10 mg 0.5% (2 mL) bupivacaine + Inj. buprenorphine (60 µg). B) Group R (n = 30); 15 mg 0.75% (2 mL) ropivacaine + Inj. buprenorphine (60 µg). Hemodynamic parameters, onset and duration of sensory, and motor blockade, level achieved, and side effects were compared between the two groups. Qualitative data were analyzed by Chi-square test and quantitative data were analyzed by independent sample t-test. Results: None of the patients in either group dropped out of the study. At the beginning of the study, patients’ demographic characteristics, hemodynamic parameters, time of onset of sensory and motor blockade, postoperative pain relief, and side effect profile were comparable between the two groups. However, 0.75% hyperbaric ropivacaine can serve as an efficacious alternative to the conventional 0.5% hyperbaric bupivacaine for patients undergoing elective cesarean section, as it produces a similar quality of block with faster attainment of desired sensory levels and early recovery from the motor blockade, thereby allowing early ambulation. Conclusion: Considering its comparable duration of sensory blockade, stable hemodynamics, and postoperative analgesia, along with a shorter duration of motor blockade, the use of 0.75% hyperbaric ropivacaine can be considered a safe and effective alternative to bupivacaine in elective LSCS.

Keywords

• cesarean section
• hyperbaric bupivacaine
• hyperbaric ropivacaine
• subarachnoid block