Comparison of Hyperbaric 0.75% Ropivacaine With 0.5% Bupivacaine for Emergency Caesarean Section under Spinal Anaesthesia: A Double Blind Randomised Controlled Trial

Abstract

Background: spinal anaesthesia provides a fast onset of block. Bupivicaine is the commonly used long acting amide local anaesthetic for spinal anaesthesia, but Bupivicaine being cardio toxic leads to exaggerated hypotension, bradycardia, high spinal and cardiac arrest. Ropivicaine is less toxic, more cardio stable drug.

Objective: This study aimed to compare Bupivacaine and Ropivacaine for spinal anaesthesia in emergency caesarean section in view of duration of motor, sensory block and hemodynamic stability.

Methods: In this prospective cohort study, 40 women aged 18–35 years undergoing emergency cesarean delivery under spinal anesthesia were randomized to receive either 0.5% hyperbaric bupivacaine or 0.75% ropivacaine. Inclusion criteria included ASA physical status I or II and term singleton pregnancy (≥37 weeks), exclusion criteria were contraindications to spinal anaesthesia and known anaesthetic allergies. Primary outcomes were motor block (Bromage scale) and sensory block duration, secondary outcomes were hemodynamic changes and adverse events. Data collection was standardized, and ethical approval was obtained, Statistical analysis was conducted using SPSS v23, employing t-tests and chi-square analysis.

Results: Showed patients who received ropiviaine 0.75 % for spinal anaesthesia had significantly stable hemodynamics and the duration of sensory block was prolonged than patients who received 0.5% bupivacaine.

Conclusion: Ropivacaine has superior hemodynamic stability, faster recovery, and improved outcomes compared to bupivacaine, in cesarean section anesthesia, leading to rapid maternal recovery.