Background: Spinal anaesthesia (SA) is the preferred technique for elective caesarean section (CS), offering rapid onset, reliable surgical conditions, and avoidance of airway manipulation 1–4. Hyperbaric bupivacaine remains standard but is associated with prolonged motor block and hypotension 3,6. Ropivacaine, a pure S-enantiomer with lower cardiotoxicity and relative sensorymotor dissociation, may facilitate earlier mobilization with a comparable sensory profile 7–9. Methods: In this single-blinded, randomized controlled trial conducted at Agartala Government Medical College 18–40 years; ≥37 to 0.05). Ropivacaine produced faster onset of sensory block to T6 (4.18 ± 0.59 vs 6.05 ± 0.70 min; p = 0.001) and faster motor block onset (8.33 ± 1.33 vs 9.39 ± 0.87 min; p = 0.01). Regression was faster with ropivacaine for both sensory (to T10: 135.1 ± 7.5 vs 156.5 ± 10.0 min; p = 0.001) and motor block (149.3 ± 10.5 vs 176.1 ± 10.5 min; p = 0.025). Duration of effective analgesia was shorter with ropivacaine (136.3 ± 7.9 vs 158.6 ± 13.4 min; p = 0.003). Haemodynamics were similar between groups intra- and postoperatively without clinically meaningful differences. Intraoperative adverse events (nausea, vomiting, shivering, hypotension, bradycardia) were numerically fewer in the ropivacaine group; differences were not statistically significant. Conclusion: Intrathecal hyperbaric ropivacaine (18 mg) provided a comparable sensory block with significantly earlier onset and faster motor recovery than hyperbaric bupivacaine (12 mg) in elective CS, enabling earlier ambulation and potentially enhancing postoperative throughput—without compromising haemodynamic stability or safety.
Sanghamitra Debbarma (Sat,) studied this question.
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