A randomized controlled trial comparing subarachnoid block with 0.75% isobaric ropivacaine (15 mg) and 0.5% hyperbaric bupivacaine (8 mg) in patients undergoing caesarean section.

Dr .B Babitha; Dr. G Alekhya; Dr. M Sreya  santhoshi

doi:10.51168/sjhrafrica.v6i12.2231

Authors

Dr. B Babitha Assistant Professor, Department of Anesthesiology , Gandhi Medical College, Secunderabad, Telangana , India.
Dr. G Alekhya Assistant Professor, Department of Anesthesiology , Gandhi Medical College, Secunderabad, Telangana , India.
Dr. M. Sreya santhoshi Assistant Professor, Department of Anesthesiology, Gandhi Medical College, Secunderabad, Telangana, India.

DOI:

https://doi.org/10.51168/sjhrafrica.v6i12.2231

Keywords:

Ropivacaine, Bupivacaine, Caesarean section, Subarachnoid block, Intrathecal anaesthesia

Abstract

Background:

Subarachnoid block (SAB) remains the preferred anaesthetic technique for lower segment caesarean section (LSCS) because it ensures rapid onset, dense surgical anaesthesia, and minimal drug transfer to the foetus.

Aim:

To compare the clinical efficacy, block dynamics, haemodynamic responses, and safety of 0.75% isobaric ropivacaine (15 mg) and 0.5% hyperbaric bupivacaine (8 mg) in parturients undergoing elective LSCS.

Methods:

A prospective, randomized comparative study was performed on 100 full-term parturients aged 18–35 years scheduled for elective LSCS under SAB. Participants were allocated to either Group I (bupivacaine 0.5%, 8 mg) or Group II (ropivacaine 0.75%, 15 mg). Sensory and motor block characteristics, haemodynamic variables, neonatal APGAR scores, and adverse events were recorded and analyzed.

Results:

Sensory block onset at T10 was faster with bupivacaine (2.28 ± 0.56 min) than with ropivacaine (3.63 ± 0.72 min; p < 0.001). Although the overall duration of sensory block was similar, regression to L1 occurred earlier with ropivacaine (p = 0.047). Motor block reached Grade III more rapidly with bupivacaine (3.06 ± 0.9 min vs 8.46 ± 2.48 min; p < 0.001) and lasted longer (129.30 ± 21.09 min vs 93.20 ± 11.10 min; p < 0.001). Haemodynamic trends and neonatal outcomes showed no significant intergroup differences. Adverse effects were infrequent and comparable.

Conclusion:

Both drugs provided reliable and safe spinal anaesthesia for caesarean delivery. Bupivacaine produced a quicker and more sustained motor block, whereas ropivacaine enabled faster postoperative recovery with stable haemodynamics. Ropivacaine may be advantageous when early ambulation and enhanced maternal comfort are priorities.

Recommendations:

Larger multicentric trials, dose-response evaluations, and assessments of adjunct use with opioids may further refine the choice of intrathecal agents for obstetric anaesthesia.

Author Biographies

Dr. B Babitha , Assistant Professor, Department of Anesthesiology , Gandhi Medical College, Secunderabad, Telangana , India.

Assistant Professor, Department of Anesthesiology, Gandhi Medical College, Secunderabad, Telangana, India. She has a strong academic orientation in obstetric anaesthesia, advanced regional anaesthesia techniques, and perioperative safety optimisation. Her work reflects a commitment to improving maternal outcomes and enhancing clinical standards in anaesthesia practice. ORCID iD: https://orcid.org/0009-0006-3517-5697

Dr. G Alekhya, Assistant Professor, Department of Anesthesiology , Gandhi Medical College, Secunderabad, Telangana , India.

Assistant Professor, Department of Anesthesiology, Gandhi Medical College, Secunderabad, Telangana, India. Her interests include neuraxial anaesthesia, maternal analgesia strategies, and the development of evidence-based perioperative protocols. She actively participates in clinical training and quality-improvement initiatives within the department. ORCID iD: https://orcid.org/0000-0001-9106-156X

Dr. M. Sreya santhoshi, Assistant Professor, Department of Anesthesiology, Gandhi Medical College, Secunderabad, Telangana, India.

Assistant Professor, Department of Anesthesiology, Gandhi Medical College, Secunderabad, Telangana, India. She is engaged in obstetric anaesthesia, intraoperative monitoring optimisation, and research focused on patient-centred perioperative care. Her academic efforts emphasise safe practice, clinical precision, and continuous improvement in anaesthetic management. ORCID iD: https://orcid.org/0009-0006-3136-6832

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