A Comparative Study of Spinal Anaesthesia With Hyperbaric Ropivacaine 0.75% and Hyperbaric Bupivacaine 0.5% in Hypertensive Patients Undergoing Lower Abdominal and Lower Limb Surgery.

BACKGROUND

Ropivacaine's stereoselective and lipophilic properties contribute to its cardiovascular stability and promote the early recovery of sensory and motor function, facilitating quicker ambulation and discharge. This study aimed to compare the hemodynamic stability measured by blood pressure and heart rate changes of intrathecal 0.75% ropivacaine versus 0.5% bupivacaine in patients with controlled hypertension undergoing spinal anaesthesia.

METHODS

Eighty patients classified as American Society of Anesthesiologists (ASA) physical status II and III with controlled hypertension were randomly assigned to either Group R (ropivacaine 0.75%, 3 mL) or Group B (bupivacaine 0.5%, 3 mL). The onset and duration of sensory and motor blockade were recorded, along with incidences of hypotension and bradycardia. Hemodynamic parameters and side effects were monitored at preset intervals during the procedure.

RESULTS

The incidence of hypotension was significantly higher in Group B compared to Group R (p<0.001), while bradycardia was more frequent in Group B but without statistical significance. Motor block duration was 130±30.42 minutes for ropivacaine versus 172±20.80 minutes for bupivacaine; sensory block lasted 160±30.42 minutes and 260±20.40 minutes, respectively.

CONCLUSION

Hyperbaric ropivacaine 0.75% provides superior spinal anaesthesia in hypertensive patients, with faster sensory and motor recovery (p<0.001), facilitating earlier ambulation and discharge. It also offers enhanced hemodynamic stability compared to equipotent hyperbaric bupivacaine 0.5%.