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Research Paper | Anaesthesiology | India | Volume 14 Issue 4, April 2025 | Popularity: 5.5 / 10
Comparison of Spinal Anaesthesia with Hyperbaric Bupivacaine, Levobupivacaine and Ropivacaine for Caesarean Section: A Prospective, Randomized, Double Blind Study
Dr. Asra Zia, Dr. Md Arman Ansari, Dr. Mohammad Saalis Pervaiz, Dr. Priya Sharma, Dr. Rakesh Kumar
Abstract: Introduction: Spinal anaesthesia with hyperbaric bupivacaine is widely used for caesarean sections but often causes hypotension. Ropivacaine and levobupivacaine, newer alternatives, offer better hemodynamic stability and reduced motor block. This study aims to evaluate and compare the quality of anaesthesia and hemodynamic characteristics of bupivacaine, ropivacaine, and levobupivacaine in caesarean section patients. Objective: The objectives of this study are to assess the time of onset and offset of sensory and motor block, evaluate the success rate of the block, determine the incidence of side effects such as hypotension, bradycardia, nausea, and vomiting, assess the quality of surgical anaesthesia, and gauge patient satisfaction regarding the anaesthesia experience. Material and methods: This prospective, randomized, double - blind study will include parturients aged over 18 years with singleton full - term pregnancies undergoing lower segment caesarean sections. Patients will be randomly assigned to receive spinal anaesthesia with either hyperbaric bupivacaine, ropivacaine, or levobupivacaine, all combined with fentanyl. Hemodynamic parameters, sensory and motor block characteristics, incidence of side effects, and patient satisfaction will be monitored and recorded throughout surgery and postoperatively. Results: A total of 180 patients were randomly allocated into three groups receiving bupivacaine, ropivacaine, or levobupivacaine for spinal anaesthesia. Sensory block onset was significantly delayed, and motor block duration was shorter in the ropivacaine group. Bupivacaine exhibited the longest two - segment regression and motor block duration. The incidence of hypotension was higher in the bupivacaine and levobupivacaine groups, while patient satisfaction and muscle relaxation were comparable across all groups. Conclusion: The study concluded that while bupivacaine provided a quicker onset and longer duration of sensory and motor block, ropivacaine exhibited faster recovery and fewer side effects, such as hypotension and bradycardia. Levobupivacaine offered similar characteristics to bupivacaine with better hemodynamic stability. Ropivacaine and levobupivacaine are safe and effective alternatives to bupivacaine for cesarean sections, especially when quicker recovery is desired.
Keywords: Analgesia, Bupivacaine, Caesarean Section, Hemodynamic Stability, Levobupivacaine, Ropivacaine
Edition: Volume 14 Issue 4, April 2025
Pages: 1088 - 1091
DOI: https://www.doi.org/10.21275/MR25326160839
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