Efficacy, Hemodynamic Stability and Safety of Hyperbaric Bupivacaine versus Hyperbaric Ropivacaine in Spinal Anaesthesia for Elective Caesarean Sections: A Randomised Controlled Trial

Background:The use of regional anaesthesia, particularly spinal anaesthesia, has transformed obstetric analgesia, especially during caesarean sections.Bupivacaine and ropivacaine are commonly used agents, each with distinct efficacy and safety profiles.Objective: This study aims to compare the efficacy and safety of hyperbaric bupivacaine versus hyperbaric ropivacaine in terms of hemodynamic changes, sensory and motor block onset, duration, and incidence of complications during elective caesarean sections.Methods: A randomized double-blinded controlled trial was conducted with 100 patients undergoing elective caesarean sections.Participants were divided into two groups: Group Ro received hyperbaric ropivacaine, and Group Bu received hyperbaric bupivacaine.Key parameters such as sensory and motor block onset times, hemodynamic stability, and complications were monitored and analysed using appropriate statistical methods. Results:The bupivacaine group exhibited a significantly quicker onset of sensory (13.2 minutes) and motor blocks (11.58 minutes) compared to the ropivacaine group (14.45 minutes and 14.25 minutes, respectively).However, the ropivacaine group had a lower incidence of hypotension (10% vs. 24% in the bupivacaine group, p=0.04), indicating better hemodynamic stability. Conclusion:While bupivacaine provides faster sensory and motor block onset, ropivacaine demonstrates a more favourable safety profile with fewer complications, particularly regarding hemodynamic stability.This suggests that ropivacaine may be a safer alternative in obstetric anaesthesia, especially for patients at risk of hypotension.