Intrathecal Hyperbaric Ropivacaine and Hyperbaric Ropivacaine with Fentanyl in Caesarean Section: A Comparative Study

Abstract

Background: Ropivacaine is considered to have more selectivity for sensory blockade with lower systemic toxicity compared to agents like bupivacaine. In this study, spinal block characteristics of hyperbaric ropivacaine with and without fentanyl in cesarean section were studied. Materials and methods: One hundred (100) parturients undergoing elective lower segment cesarean section (LSCS) were recruited in this randomized double-blind controlled study. They were allocated into two groups: Group A-15mg 0.6% hyperbaric ropivacaine and Group B-13.2 mg of 0.6% hyperbaric ropivacaine + 15µg fentanyl intrathecally. The spinal block characteristics in the two groups were assessed along with the intraoperative hemodynamic changes. The results obtained were statistically analyzed and p<0.05 was considered statistically significant. Results: The sensory onset time in Group A and Group B were 3.23±0.57 vs. 1.55±0.37 (p<0.001) and the motor onset time to Bromage 1 (min) was 3.84±0.60 and 2.60±0.47 (p<0.001) respectively. The mean peak sensory block level (MPSBL) between group A & group B were (T4/T6:39/11 vs. 50/0); p<0.001. Sensory block regression to T10 in between the two groups were group A (110.16±6.82) vs. group B (119.74±5.97);(p<0.001). Conclusion: Intrathecal fentanyl as adjuvant to hyperbaric ropivacaine provided faster onset and longer duration of sensory block, early recovery from motor block, better hemodynamic stability without any significant side effects than hyperbaric ropivacaine alone for lower segment caesarean section.