Comparison Of Hyperbaric Ropivacaine With Fentanyl Versus Hyperbaric Bupivacaine With Fentanyl In Elective Surgical Patients Undergoing Lower Abdominal Surgery Under Spinal Anaesthesia

Abstract

Ropivacaine is considered an alternative to bupivacaine due to its lower cardiovascular complications. However, controversy exists regarding their efficacy, with some studies suggesting equivalent action and others reporting that ropivacaine produces less motor blockade. This study aimed to compare the effects of equipotent doses of ropivacaine with fentanyl and bupivacaine with fentanyl in spinal anaesthesia for lower abdominal surgery, focusing on hemodynamic stability, sensory and motor blockade, and recovery profiles. This study was aimed To compare the equipotent doses of intra thecal 0.75% hyperbaric ropivacaine-fentanyl and 0.5% hyperbaric bupivacaine-fentanyl for lower abdominal surgeries under spinal anaesthesia, in terms of hemodynamic stability, duration  of sensory blockade, and motor blockade. In this study, 100 adult Patients (ASA I/II, aged 20–55 years) undergoing elective lower abdominal surgery under spinal anaesthesia were included. Patients were equally divided into two groups. Group R: 0.75%Ropivacaine Heavy (19.5 mg=2.6ml)+fentanyl(20 µg=0.4ml) was administered intrathecally Group B: 0.5% Bupivacaine Heavy (13 mg=2.6ml) + fentanyl (20 µg=0.4ml) was administered intrathecally Hemodynamic parameters (Heart rate, blood pressure ,oxygen saturation), sensory/motor block onset/duration, and regression times were recorded. There was not a statistically significant difference in heart rate and blood pressure except around 30 to 45 minutes after spinal blockade (hemodynamic parameter) between the groups. But, Ropivacaine-fentanyl provided shorter motor blockade duration compared to Bupivacaine (163.24 ± 34.13 min vs. 217.12 ± 35.48 min, *p* = 0.0001), facilitating faster postoperative mobilization. Additionally Sensory regression was slower with ropivacaine when compared to Bupivacaine (181.04 ± 19.29 min vs. 148.04 ± 14.94 min, *p* = 0.0001). Based on this study, it was concluded that Ropivacaine-fentanyl offered comparable hemodynamic stability to bupivacaine-fentanyl but with shorter motor block duration, making it advantageous for early postoperative recovery and early mobilisation.