##submission.abstract##
Background: Hyperbaric bupivacaine has traditionally been the standard local anaesthetic for spinal anaesthesia in caesarean section, but its use is associated with a relatively high incidence of maternal hypotension. Ropivacaine, with its reported lower cardiotoxicity and motor-sparing profile, has been proposed as an alternative.2,7
Objectives: To compare block characteristics, haemodynamic stability, and neonatal outcome between hyperbaric bupivacaine and hyperbaric ropivacaine for spinal anaesthesia in elective lower segment caesarean section (LSCS).
Methods: This was a prospective, randomised, comparative study of 80 parturients undergoing elective LSCS under spinal anaesthesia, allocated to receive either hyperbaric bupivacaine 0.5% (Group A, n=40) or hyperbaric ropivacaine 0.75% (Group B, n=40). Onset and duration of sensory and motor block, haemodynamic parameters, incidence of hypotension, side effects, and neonatal APGAR scores were recorded and compared.
Results: Onset of sensory block was faster with bupivacaine (3.2 ± 0.8 min) than ropivacaine (4.1 ± 0.9 min, p=0.001). Duration of motor block was longer with bupivacaine (145.6 ± 18.2 min) than ropivacaine (118.3 ± 15.7 min, p<0.001). Hypotension occurred in 32.5% of the bupivacaine group compared with 15.0% of the ropivacaine group. Neonatal APGAR scores were comparable between groups.
Conclusion: Hyperbaric ropivacaine provides effective spinal anaesthesia for caesarean section with greater haemodynamic stability and a lower incidence of hypotension compared with hyperbaric bupivacaine, albeit with a slightly slower onset and shorter duration of motor block, and represents a suitable alternative in this setting.