A Prospective Randomized Comparative Study of Hyperbaric Ropivacaine vs. Hyperbaric Bupivacaine in Spinal Anesthesia for Elective Infraumbilical Surgeries

Commercially available hyperbaric ropivacaine 0.75% has recently been gaining clinical acceptance for spinal anesthesia. However, limited studies are available comparing hyperbaric ropivacaine 0.75% with hyperbaric bupivacaine 0.5%. We hypothesized that ropivacaine, a pure S-enantiomer of bupivacaine, has a better clinical profile. We therefore compared the efficacy and safety of the two drugs. In this prospective, randomized, double-blind trial, 60 patients who belonged to the American Society of Anesthesiologists physical status I and II, undergoing elective infraumbilical surgeries were allocated into two groups: Group B (0.5% hyperbaric bupivacaine) and Group R (0.75% hyperbaric ropivacaine), respectively. The primary objective of this study was to compare the time to onset and duration of both sensory and motor blockade between both groups. Chi-square test was used for qualitative variables and independent t-test for quantitative data. P < 0.05 was considered statistically significant. The mean time to sensory and motor onset was longer in Group R (5.93 ± 1.86 min and 10.53 ± 2.03 min) when compared with Group B (3.20 ± 1.24 min and 7.93 ± 2.13 min) while the mean sensory and motor duration was shorter in Group R (146.57 ± 15.60 min and 108.87 ± 25.33 min) as compared with Group B (179.30 ± 21.35 min and 135 ± 14.10 min), both of which were statistically significant. Hyperbaric ropivacaine 0.75% has a slower onset and longer time to maximum spread but faster recovery, making it a safe alternative to bupivacaine.