Block characteristics of hyperbaric bupivacaine versus hyperbaric ropivacaine in lower segment cesarean section: A randomized experimental study

Abstract

Introduction: Bupivacaine is used most commonly for spinal anesthesia, however the major concern is longer duration and cardiotoxicity, that led us to find safe alternative with shorter duration. Hence, we compared routinely used hyperbaric bupivacaine with recently available hyperbaric ropivacaine in terms of block characteristics in caesarean section (CS). Objective: To compare the efficacy and safety of hyperbaric ropivacaine and bupivacaine in spinal anesthesia for elective CS with primary outcome as onset of sensory block at T 10 level & secondary outcomes as onset of motor block, grading & duration of sensory and motor block, duration of analgesia, hemodynamic changes & side effects. Methodology: Eighty parturients with ASA grade ІІ undergoing elective CS were allocated into two groups (n=40): group R (2 ml hyperbaric ropivacaine 0.75%) and group B (2 ml hyperbaric bupivacaine 0.5%). Result: Though onset of sensory block (group B 3.40±0.63 min & in group R 4.13±0.79min) & motor block (group B 5.28±0.82 min & group R 7.10±0.84min) (p<0.001) were significantly shorter in group B, but duration of sensory & motor block and duration of analgesia was significantly shorter in group R (p<0.001). Incidence of side effects (i.e. hypotension, nausea & vomiting, shivering) was comparable in both the groups. Conclusion: Ropivacaine can be preferred as an alternative to bupivacaine for spinal anesthesia in cesarean section because of early recovery & lesser side effects.