Abstract

Introduction: Spinal anesthesia is a preferred technique for infraumbilical surgeries due to its rapid, reliable action and minimal systemic effects. While hyperbaric bupivacaine provides effective sensory and motor blockade, its potential for hypotension and bradycardia has led to interest in alternatives like hyperbaric ropivacaine, which offers comparable anesthesia with potentially better hemodynamic stability. This study aimed to compare the hemodynamic effects and analgesic efficacy of hyperbaric bupivacaine and ropivacaine, both combined with fentanyl, in infraumbilical surgeries. Methodology: In this randomized, double-blind trial, 70 patients undergoing elective infraumbilical surgeries were allocated equally to receive spinal anesthesia with either hyperbaric bupivacaine 0.5% or hyperbaric ropivacaine 0.75%, both with 25 mcg fentanyl. Sensory and motor block onset times, intraoperative hemodynamics, side effects, and postoperative pain scores via Numeric Rating Scale (NRS) were recorded and analyzed. Results: Groups were comparable demographically. Bupivacaine had a significantly faster onset of sensory (3.55 ± 0.19 vs 4.10 ± 0.27 min, P<0.001) and motor blockade (6.91 ± 0.25 vs 9.85 ± 0.24 min, P<0.001) and longer time to first rescue analgesia (227.8 ± 8.7 vs 209.9 ± 6.9 min, P<0.001). Although hypotension was more frequent with bupivacaine (42.85% vs 25.71%), differences were not statistically significant. Postoperative pain scores were similar in both groups at all assessed intervals. Conclusion: Both anesthetics provide effective spinal anesthesia in infraumbilical surgeries. Bupivacaine offers faster block onset and longer analgesia, while ropivacaine presents improved hemodynamic stability, making it suitable for patients needing rapid recovery or cardiovascular caution.