Ropivacaine has a better safety profile than Bupivacaine as it is less cardiotoxic and neurotoxic . Dexmedetomidine is a highly selective alpha 2 agonist, as adjuvant prolongs duration and provides stable hemodynamic condition during spinal anaesthesia. The purpose of the study was to compare the two local anaesthetics with respect with duration of block as well as hemodynamic changes and level of sedation

In this randomised double blind study, 60 patients undergoing major gynaecological surgeries under SAB were allocated to group B ( receiving Bupivacaine 0.5% hyperbaric 2.5 ml) and group R(receiving Ropivacaine 0.75% isobaric 2.5ml). Both groups received Dexmedetomodine 5 mcg. The onset and regression of sensory and motor block, hemodynamic changes and level of sedation were recorded. General anaesthesia was supplemented in patients with failure of SAB.

The time of onset of sensory block in group B was significantly shorter to reach a level of T5( 7.4±1.8 min) compared to group R (11.38±1.8 min) with p <0.001. Two segment regression was faster in group R (112±12.6 min) compared to group B (124 ±14.6 min) (p < 0.001). Time of regression to S1 was longer in group B ( 466±18.6 min) than Group R (430±20.4 min)(p < 0.001). Hemodynamics and sedation in both groups were similar. None of the patients had failure of subarachnoid block.

Dexmedetomidine with Ropivacaine had slower onset and faster recovery compared to Dexmedetomidine with Bupivacaine. Ropivacaine with dexmedetomidine is a suitable alternative to Bupivacaine with dexmedetomidine for major gynaecological surgeries.