A Comparative Study of Hyperbaric Ropivacaine with Fentanyl and Hyperbaric Bupivacaine with Fentanyl in Subarachnoid Block for Lower Limb Surgeries

Abstract

Introduction: Subarachnoid block, commonly referred to as a spinal anaesthesia, is a highly effective regional anaesthesia technique that is simple to master. It provides dense sensory, motor and sympathetic block with very few adverse effects. Spinal anaesthesia involves the deposition of local anaesthetic directly into the cerebrospinal fluid. The dense sensory and motor block produced by spinal anaesthesia necessitates a low amount of local anaesthetic, thus reducing the risk of systemic toxicity. Hyperbaric bupivacaine has been a standard choice for subarachnoid block (SAB), but hyperbaric ropivacaine has gained interest due to its potentially favourable safety profile. The addition of fentanyl as an adjuvant enhances the quality and duration of analgesia. This study aims to compare the efficacy and safety of subarachnoid hyperbaric 0.75% ropivacainefentanyl with hyperbaric 0.5% bupivacaine-fentanyl for lower limb surgeries. Material and Methods: A prospective, randomized, singleblind, observational study was conducted on patients undergoing elective lower limb surgeries. Participants were divided into two groups: Group A received 2.8 mL hyperbaric ropivacaine (0.75%) with fentanyl (25 mcg), and group B received 2.8 mL hyperbaric bupivacaine (0.5%) with fentanyl (25 mcg). The onset and duration of sensory and motor blockade, hemodynamic parameters and adverse effects were recorded and analysed. Results: Both groups achieved effective anaesthesia, but group A exhibited a slower onset and shorter duration of motor blockade compared to group B. Hemodynamic stability was significantly better in the ropivacaine group, with fewer instances of hypotension and bradycardia. Conclusion: H yperbaric r opivacaine w ith f entanyl p rovides effective anaesthesia with improved hemodynamic stability and a shorter motor blockade duration compared to hyperbaric bupivacaine with fentanyl. These findings suggest that hyperbaric ropivacaine may be a safer alternative in patients where hemodynamic stability is a concern, making it a valuable option for lower limb surgeries under SAB.