Comparison of different doses of intrathecal buprenorphine with 0.75% hyperbaric ropivacaine in caesarean section patients

: Spinal anesthesia (SA) is widely considered the preferred technique for performing Cesarean sections (CS) due to its safety and effectiveness. The present study aimed to evaluate the benefits of combining Buprenorphine with hyperbaric Ropivacaine for SA in CS and to identify the optimal dose of Buprenorphine that provides the best balance between enhanced analgesia and minimal side effects. : This prospective, randomized, single-blind study included 150 patients undergoing elective Cesarean section. Participants were randomly assigned into three groups (n=50 each). Group A received 1.9 ml (14.25 mg) of 0.75% hyperbaric Ropivacaine combined with 30 μg of Buprenorphine. Group B received 1.8 ml (13.5 mg) of 0.75% hyperbaric Ropivacaine with 60 μg of Buprenorphine, while Group C (control group) received 2 ml (15 mg) of 0.75% hyperbaric Ropivacaine without Buprenorphine. The primary outcomes measured were the onset time and duration of sensory and motor blocks. Secondary outcomes included the duration of postoperative analgesia and neonatal safety, which was assessed using the APGAR scoring method. Statistical analysis was performed using the chi-square test and the t-test to compare the efficacy and safety across groups. The addition of Buprenorphine significantly accelerated the onset of sensory block in both Group A (1.49 ± 0.40 minutes) and Group B (1.92 ± 0.63 minutes), compared to the control Group C (4.94 ± 0.90 minutes). The duration of sensory block was also prolonged in Groups A (4.34 ± 0.24 hours) and B (4.55 ± 0.38 hours) compared to Group C (2.10 ± 0.18 hours). Group B, which received the higher dose of Buprenorphine (60 μg), exhibited the longest duration of analgesia with no observed neonatal side effects according to the APGAR scores. The addition of Buprenorphine to hyperbaric Ropivacaine for spinal anesthesia in Cesarean sections enhances anesthetic efficacy by accelerating the onset and extending the duration of sensory and motor blocks. The use of 60 μg Buprenorphine provided the greatest duration of postoperative analgesia without compromising neonatal outcomes. These findings support the use of Buprenorphine as an effective adjuvant in spinal anesthesia for Cesarean deliveries.