Commercial preparations of hyperbaric ropivacaine 0.75% have been increasingly used for spinal anesthesia, but direct comparisons with the commonly used hyperbaric bupivacaine 0.5% remain limited. The authors hypothesized that ropivacaine, as a pure S-enantiomer of bupivacaine, could offer a different clinical profile with potential advantages. This prospective trial aimed to compare the efficacy and safety of hyperbaric ropivacaine 0.75% versus hyperbaric bupivacaine 0.5% in elective infraumbilical surgeries.
The study was conducted as a prospective, randomized, double-blind trial. Sixty patients scheduled for elective infraumbilical procedures and classified as American Society of Anesthesiologists (ASA) physical status I or II were enrolled and randomized into two groups. Group B received 0.5% hyperbaric bupivacaine, whereas Group R received 0.75% hyperbaric ropivacaine.
The primary objectives were predefined as comparison of the time to onset and the duration of both sensory and motor blockade for the two study drugs. For statistical analysis, qualitative variables were assessed with the chi-square test and quantitative variables with the independent t-test. A P value less than 0.05 was considered statistically significant.
Sixty ASA I–II patients were randomized evenly into two groups (Group B and Group R). Detailed demographic data, inclusion/exclusion criteria, exact dosing volumes, needle sizes, patient positioning, and intraoperative management parameters were not reported in the abstract. The trial was double-blinded with allocation concealed from the investigators assessing outcomes.
Primary endpoints were the time to onset of sensory and motor block and the duration of sensory and motor blockade. Statistical methods reported were the chi-square test for categorical data and the independent t-test for continuous variables, with significance threshold at P < 0.05.
Mean times to onset were reported as follows:
Both sensory and motor onset times were longer in the ropivacaine group compared with the bupivacaine group, and these differences were statistically significant according to the authors.
Reported mean durations were:
Sensory and motor block durations were shorter with ropivacaine than with bupivacaine; these differences were also statistically significant as reported in the abstract.
The abstract concludes that hyperbaric ropivacaine 0.75% showed a slower onset and longer time to maximum spread but faster recovery compared with hyperbaric bupivacaine 0.5%, and that ropivacaine can be considered a safe alternative. Specific adverse events, perioperative hemodynamic data, or detailed safety outcomes were not provided in the abstract.
Authorship and affiliations for all listed authors are reported; the authors declare no disclosures. Funding was provided by the Postgraduate Medical Research Grant of Manipal Academy of Higher Education, Manipal, Karnataka, India (grant number PGR704).
In this randomized double-blind trial of 60 ASA I–II patients undergoing elective infraumbilical surgery, hyperbaric ropivacaine 0.75% produced a statistically significant slower onset of both sensory and motor block and a shorter duration of sensory and motor blockade compared with hyperbaric bupivacaine 0.5%. The authors interpret these findings to mean that ropivacaine yields a longer time to maximum spread but faster recovery, supporting its use as a safe alternative when a shorter duration of block or earlier ambulation is desirable.
Limitations of the report in the abstract include absence of detailed adverse-event reporting, lack of granular intraoperative data, and absence of specifics on technique variables; these details were not reported in the source abstract.