Comparison of Efficacy of Epidural Ropivacaine versus Bupivacaine for Postoperative Pain Relief in Patients Undergoing Infraumbilical Surgeries
M. Rasika Priya, Sankami Tamilarasan, G. Pramodh Roshan, R. Brindha, Senthil MarappanAbstract
Background:
Effective postoperative pain control is a cornerstone of enhanced recovery after surgery, facilitating early ambulation, reducing complications, and improving patient satisfaction. Epidural analgesia remains a widely used and reliable technique for postoperative pain management following infraumbilical surgeries. Bupivacaine has long been considered a standard agent for epidural infusion; however, concerns regarding cardiotoxicity and motor blockade have prompted interest in ropivacaine, which is associated with a more favorable safety profile. This study was designed to compare the efficacy and safety of epidural bupivacaine 0.125% and ropivacaine 0.2% for postoperative analgesia.
Materials and Methods:
This prospective randomized study included 90 patients aged 18–70 years with American Society of Anesthesiologists physical status I and II undergoing infraumbilical surgeries under spinal anesthesia. Patients were randomly allocated into two groups of 45 each. Group B received epidural infusion of 0.125% bupivacaine at 6 ml/h, and Group R received epidural infusion of 0.2% ropivacaine at 6 ml/h. Postoperative pain was assessed using the Visual Analog Scale (VAS). Hemodynamic parameters, time to first rescue analgesia, total number of rescue analgesics required, and adverse effects were recorded over a 12-h postoperative period.
Results:
VAS scores showed a significant difference at the 3 rd and 4 th postoperative hours, with higher pain scores observed in the ropivacaine group. The mean time to first rescue analgesia was significantly longer in the bupivacaine group compared with the ropivacaine group. The total number of rescue analgesics required during the observation period was comparable between the two groups. Hemodynamic parameters, including heart rate and blood pressure, were significantly higher in the ropivacaine group during the initial postoperative hours, although these differences were transient. The incidence of adverse effects such as hypotension, nausea, vomiting, and bradycardia was similar in both groups.
Conclusion:
Epidural bupivacaine provides a longer duration of postoperative analgesia with better early pain control, whereas ropivacaine offers a favorable safety profile with less motor blockade and acceptable hemodynamic stability. Ropivacaine may be considered a suitable alternative to bupivacaine for postoperative epidural analgesia in patients undergoing infraumbilical surgeries.