Comparative Evaluation of the Efficacy and Safety of 0.5% Hyperbaric Ropivacaine Versus 0.5% Hyperbaric Bupivacaine in Spinal Anaesthesia-150 Cases

Open Access

Abstract

Background: Spinal anaesthesia is widely used for lower abdominal and lower limb surgeries due to its rapid onset, effective sensory and motor blockade, and favorable safety profile. Bupivacaine has long been the standard agent; however, ropivacaine has emerged as a safer alternative with lower cardiotoxicity and faster recovery. This study aimed to compare the efficacy and safety of 0.5% hyperbaric ropivacaine versus 0.5% hyperbaric bupivacaine in spinal anaesthesia. Methods & Materials: A prospective, randomized study was conducted on 150 adult patients (ASA I–II) undergoing elective lower abdominal or lower limb surgeries. Patients were randomly allocated to receive either 0.5% hyperbaric ropivacaine (Group R, n=75) or 0.5% hyperbaric bupivacaine (Group B, n=75). Sensory and motor block onset, duration, regression, hemodynamic parameters, adverse effects and recovery times were recorded. Data were analyzed using Student’s t-test and Chi-square test, with p<0.05 considered significant. Results: Both agents provided effective spinal anaesthesia. Sensory block onset was slightly faster with bupivacaine (4.2 ± 1.0 min) compared to ropivacaine (4.8 ± 1.2 min; p=0.02), but maximum sensory levels were similar (T6–T8). Motor block onset was comparable while ropivacaine demonstrated faster motor recovery (150 ± 25 min vs. 180 ± 30 min; p<0.01), allowing earlier ambulation (180 ± 28 min vs. 210 ± 32 min; p<0.01). Hemodynamic stability was superior with ropivacaine, showing lower incidences of hypotension (12% vs. 28%) and bradycardia (8% vs. 18%). Adverse effects were minimal and comparable between groups. Time to first voiding and discharge readiness were shorter in the ropivacaine group. Conclusion: 0.5% hyperbaric ropivacaine is a safe and effective alternative to 0.5% hyperbaric bupivacaine for spinal anaesthesia. While bupivacaine provides a slightly faster sensory onset, ropivacaine allows faster motor recovery, earlier ambulation, and better hemodynamic stability, making it particularly advantageous for day-care or short-stay surgical procedures.