Comparing the Effect of Bupivacaine and Ropivacaine in Cesarean Delivery with Spinal Anesthesia

Abstract

Background: Spinal anesthesia is the most common technique used for cesarean delivery due to some advantages compared to regional anesthesia. It is easily performed and provides a rapid onset of block. Though bupivacaine is a generally used long-acting amide type local anesthetic drug for spinal anesthesia, ropivacaine may sometimes be selected. Objectives: This prospective, randomized, double-blinded study was aimed at comparing clinical efficacy and safety between ropivacaine and bupivacaine during cesarean section. Methods: After getting ethical committee approval and written informed consent, 65 women who referred to Imam Khomeini Hospital of Ahvaz, Iran in 2018 were chosen for elective cesarean delivery under spinal anesthesia. They were randomly allocated to receive either ropivacaine 1% (n = 33) or bupivacaine 0.5% (n = 32). Afterwards, the differences in the anesthetic efficacy, vital signs, and hemodynamics of participants between the two groups were recorded. Results: Duration of sensory block was shorter in the ropivacaine group than bupivacaine group (132.5 ± 21.6 min vs. 175.8 ± 26.2 min; P < 0.001). Ropivacaine also produced a shorter duration of motor blockade than bupivacaine (124.8 ± 20.2 min vs. 168.2 ± 21.7 min; P < 0.001). There is no difference between the two groups in terms of systolic and diastolic blood pressure, but the heart rate of patients in the bupivacaine group is significantly higher than the ropivacaine group. Conclusions: The results suggest that ropivacaine and bupivacaine are two efficient drugs in anesthesia in the cesarean section, ropivacaine is a better choice due to little influence on the hemodynamics and shorter duration of sensory block and motor block which are useful for the recovery and also safe to the patients.

Effectiveness of Spinal Analgesia for Labor Pain Compared with Epidural Analgesia

“…Moreover, a spinal block technique can take a shorter time than an epidural block (3). Some studies mentioned that spinal analgesia not only can be applied more easily but also is faster, less expensive, and more effective than epidural analgesia (4)(5)(6)(7)(8)(9)(10)(11). Administration of opioid drugs in neuraxial blocks, which do not affect the sympathetic activity, along with local anesthetics, is a common technique to avoid negative consequences such as hypotension in these techniques (12)(13)(14)(15)(16).…”

Incidence of Hypotension and Associated-risk Factors in Epidural Anesthesia With 2% Lidocaine and Epinephrine During Elective Cesarean Section, Efficacy and Safety Assessment

“…It is actually known that epinephrine has some properties of antinociceptive and enhances the duration of analgesia used together with LAs [39,40] . Furthermore, recent researches by Aliza Olapour et al [41] said that lidocaine's sensory and motor block were superior to the Ropivacaine's, and epinephrine was found to exert an essential role [39] . Moreover, Meechan and co-authors [42] let know that anesthesia effects of ropivacaine in their study were inferior to those with lidocaine-epinephrine.…”

Anesthetic Conversion of Preexisting Labor Epidural Analgesia for Emergency Cesarean Section and Efficacy of Levobupivacaine with or Without Magnesium Sulphate: A Prospective Randomized Study

“…Bupivacaine, alone or with different adjuvants, is the most common drug used for CS, and it has a deep and prolonged sensory block (9). Because levobupivacaine is a pure levo-isomer, it has a lower cardiac or neurotoxic effect than racemic bupivacaine.…”