1*Final Year Postgraduate, Department of Anesthesiology and Critical Care, Sree Balaji Medical College and Hospital, Bharath Institute of Higher Education and Research, Tamil Nadu, India. ORCID: 0009-0000-8855-8006. Email: pavithravi76@gmail.com. Corresponding Author.
2Freelance Anaesthetist, Chennai, Tamil Nadu, India. ORCID: 0009-0000-2285-6115. Email: roshniciyer@gmail.com
3Assistant Professor, Department of Anesthesiology, Sree Balaji Medical College and Hospital, Bharath Institute of Higher Education and Research, Tamil Nadu, India. ORCID: 0000-0002-6202-0424. Email: purushmbbs@gmail.com
Received: 12th Dec, 2025; Revised: 12th Feb 2026; Accepted: 13th Feb, 2026; Available Online: 10th March, 2026
Background:
Spinal anesthesia remains the gold standard for infraumbilical surgeries due to its ability to provide dense sensory and motor blockade with minimal systemic interference. For decades, racemic bupivacaine was the agent of choice; however, concerns regarding its potential for cardiotoxicity and neurotoxicity led to the development of pure S-enantiomers: Levo-bupivacaine and Ropivacaine. While both agents are widely used, debate persists regarding their equipotent doses and blockade characteristics. Levo-bupivacaine is often cited as being equipotent to bupivacaine, whereas Ropivacaine is considered less potent, necessitating higher concentrations. This study aims to evaluate and compare the anesthetic efficacy of 0.5% hyperbaric Levo-bupivacaine and 0.75% hyperbaric Ropivacaine.
Methods:
This prospective observational study was conducted at a tertiary care teaching hospital in Chennai, India, from March 2023 to March 2024. The study enrolled 58 patients aged 18–60 years, classified as ASA physical status I and II, undergoing elective infraumbilical surgeries. Patients were divided into two groups: Group L received 3 ml of 0.5% Levo-bupivacaine heavy, and Group R received 3 ml of 0.75% Ropivacaine heavy. The primary outcomes measured were the onset time, peak dermatome level, and total duration of sensory block (assessed by pinprick) and motor block (assessed by Modified Bromage Scale).
Results:
The demographic profiles were comparable between the two groups (p > 0.05). The mean onset of sensory block was 8.5 ± 1.2 min in Group L and 7.9 ± 1.3 min in Group R (p=0.20). Both groups achieved a median peak sensory level of T8. The total duration of sensory block was 180.5 ± 25.0 min for Levo-bupivacaine and 175.3 ± 24.5 min for Ropivacaine (p=0.40). Regarding motor blockade, the onset of complete motor block was 10.2 ± 1.5 min in Group L versus 9.8 ± 1.6 min in Group R (p=0.30), and the total duration of motor block was 150.7 ± 20.3 min versus 148.4 ± 19.8 min (p=0.45).
Conclusion:
Intrathecal 0.5% Levo-bupivacaine heavy and 0.75% Ropivacaine heavy exhibit clinically indistinguishable sensory and motor block characteristics. Ropivacaine, at a higher concentration (0.75%), provides an anaesthetic profile equipotent to 0.5% Levo-bupivacaine, making both viable options for infraumbilical surgeries.
Keywords: Spinal anaesthesia, Levo-bupivacaine, Ropivacaine, Sensory blockade, Motor blockade, Pharmacodynamics, Infraumbilical surgery.
How to cite this article: Ravichandran P, Roshini C, Ramamurthy P. Comparative Evaluation of Sensory and Motor Block Characteristics of Intrathecal 0.5% Hyperbaric Levo-Bupivacaine versus 0.75% Hyperbaric Ropivacaine in Infraumbilical Surgeries: A Prospective Observational Study. Int J Drug Deliv Technol. 2026;16(3): 570-577. DOI: 10.25258/ijddt.16.3.64
Source of support: Nil.
Conflict of interest: None