Comparative Evaluation of Intrathecal Hyperbaric Ropivacaine versus Hyperbaric Bupivacaine in Elective Surgery under Spinal Anaesthesia – A Prospective, Randomised, Double-blind Study

Abstract Introduction: Regional anaesthesia offers faster recovery than general anaesthesia. Ropivacaine, a newer local anaesthetic, is safer than bupivacaine, with less cardiotoxicity and neurotoxicity. It produces effective sensory analgesia with less motor block, aiding early ambulation. This study aims to compare the efficacy and safety of hyperbaric ropivacaine versus bupivacaine. Materials and Methods: After receiving informed consent, this study randomised 100 American Society of Anaesthesiologists I/II patients undergoing lower body surgery into two groups ( n = 50). Group R received intrathecal hyperbaric ropivacaine, while Group B received hyperbaric bupivacaine. Researchers assessed the onset and duration of sensory (pinprick) and motor (Bromage scale) blocks. Haemodynamic parameters were continuously monitored throughout the procedure and postoperatively, with established protocols to manage adverse events such as hypotension and bradycardia. Results: With comparable demographics, the ropivacaine group showed a significantly faster onset but shorter duration of sensory and motor block compared to bupivacaine. Haemodynamic stability was notably better with ropivacaine, as the bupivacaine group experienced a significantly higher incidence of hypotension ( P < 0.001), while other side effects were similar. Conclusions: Our study concludes that hyperbaric ropivacaine is a superior alternative to hyperbaric bupivacaine for spinal anaesthesia, offering excellent block quality, greater haemodynamic stability and a duration well-suited for shorter surgeries.