Hyperbaric Ropivacaine useful alternative to bupivacaine for spinal anesthesia with better motor recovery profiles: Study

Recently published study investigated the efficacy and safety of hyperbaric 0.75% ropivacaine compared to 0.5% bupivacaine in spinal anesthesia for patients undergoing infra-umbilical surgeries. The double-blind, randomized, active-controlled, parallel arm study involved 60 patients and focused on parameters like onset and duration of sensory and motor block, time to rescue analgesia, hemodynamics, and safety. Results indicated a slower onset but faster regression of sensory and motor blockades with ropivacaine compared to bupivacaine. However, the duration of sensory blockade and requirement for rescue analgesia were comparable between the two drugs. Ropivacaine also caused fewer side effects. The study highlighted that the equipotent dose of 0.75% ropivacaine proved to be a comparable and safer alternative to 0.5% bupivacaine, with better motor recovery profiles. However, it suggested caution for time-sensitive cases due to the slower onset of ropivacaine.

The study employed a computer-generated random number table for patient allocation into groups, ensuring the double-blinding of participants and proper ethical considerations. The physical characteristics of the two groups were comparable, and the study found delayed sensory and motor block onset with ropivacaine, but a comparable total duration of sensory blockade and time required for rescue analgesia. Hemodynamic changes, incidence of bradycardia, nausea, vomiting, and shivering did not significantly differ between the two groups. The study concluded that 0.75% hyperbaric ropivacaine demonstrated clinically effective anesthesia and suggested its potential as an efficient and safe alternative to the commonly used bupivacaine in routine clinical practice.