Hyperbaric spinal ropivacaine for cesarean delivery: a comparison to hyperbaric bupivacaine.

We evaluated the clinical efficacy and safety of spinal anesthesia with 0.5% hyperbaric ropivacaine compared with 0.5% hyperbaric bupivacaine for elective cesarean delivery. Sixty healthy, full-term parturients were randomly assigned to receive either 12 mg of 0.5% hyperbaric bupivacaine or 18 mg of 0.5% hyperbaric ropivacaine intrathecally. There were no significant differences in demographic or surgical variables or neonatal outcomes between groups. Onset time of sensory block to T10 or to peak level was later in the Ropivacaine group (P < 0.05). The median (range) peak level of analgesia was T3 (T1-5) in the Bupivacaine group and T3 (T1-4) in the Ropivacaine group. Time for sensory block to recede to T10 did not differ between groups. Duration of sensory block was shorter in the Ropivacaine group (188.5 +/- 28.2 min vs 162.5 +/- 20.2 min; P < 0.05). Complete motor block of the lower extremities was obtained in all patients. Ropivacaine also produced a shorter duration of motor blockade than bupivacaine (113.7 +/- 18.6 min vs 158.7 +/- 31.2 min; P < 0.000). The intraoperative quality of anesthesia was excellent and similar in both groups. Side effects did not differ between groups. Eighteen milligrams of 0.5% hyperbaric ropivacaine provided effective spinal anesthesia with shorter duration of sensory and motor block, compared with 12 mg of 0.5% hyperbaric bupivacaine when administered for cesarean delivery Implications: Eighteen milligrams of 0.5% hyperbaric ropivacaine provided effective spinal anesthesia with shorter duration of sensory and motor block, compared with 12mg of 0.5% hyperbaric bupivacaine when administered for cesarean delivery.