Analgesic Efficacy of Hyperbaric Ropivacaine versus Hyperbaric Bupivacaine with Fentanyl in Infraumbilical Surgeries under Spinal Anaesthesia: A Double-blinded Randomised Clinical Trial

Introduction: Spinal anaesthesia is a preferred technique for infraumbilical surgeries because of its rapid onset, reliable action, and minimal systemic effects. Although hyperbaric bupivacaine provides effective sensory and motor blockade, its association with hypotension and bradycardia has prompted interest in alternatives such as hyperbaric ropivacaine, which offers comparable anaesthesia with potentially better haemodynamic stability. Aim: To compare the haemodynamic effects and analgesic efficacy of hyperbaric bupivacaine and hyperbaric ropivacaine, both combined with fentanyl, in patients undergoing infraumbilical surgeries under spinal anaesthesia. Materials and Methods: This randomised, double-blind clinical trial included 70 patients undergoing elective infraumbilical surgeries over a period of two years at Sikkim Manipal Institute of Medical Sciences, Gangtok, Sikkim, India. Patients were equally allocated to receive spinal anaesthesia with either hyperbaric bupivacaine 0.5% or hyperbaric ropivacaine 0.75%, both combined with 25 μg fentanyl. Sensory and motor block onset times, intraoperative haemodynamic parameters, side-effects, and postoperative pain scores assessed using the Numeric Rating Scale (NRS) . Data were compared between groups using the unpaired Student’s t-test, with p-value