DOI: https://doi.org/10.14710/jai.v0i0.67832

Comparison of the Effectiveness of Local Anesthetic Infiltration Of 0.25% Ropivacaine And 0.375% Ropivacaine on Cesarean Section Incision with Spinal Anesthesia

1Department of Anesthesiology and Intensive Care, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia

2Department of Community Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia

Received: 31 Oct 2024; Revised: 15 Jan 2026; Accepted: 26 Jan 2026; Available online: 26 Jan 2026.
Open Access Copyright 2026 JAI (Jurnal Anestesiologi Indonesia)
Creative Commons License This work is licensed under a Creative Commons Attribution 4.0 International License.

Citation Format:
Cover Image
Abstract

Background: Postoperative discomfort subsequent to a caesarean delivery significantly influences the recuperation process and necessitates efficacious therapeutic intervention. Ropivacaine is a local anesthetic used to manage this pain, but there is limited comparison between its 0.25% and 0.375% concentrations.

Objective: To evaluate the comparative efficacy of varying dosages of ropivacaine, specifically 0.25% and 0.375% concentrations, as local anesthetic infiltrates during the surgical procedure of Cesarean section incision.

Methods: This randomized controlled trial (RCT) encompassed a cohort of 60 patients who underwent cesarean sections utilizing spinal anesthesia at Adam Malik Hospital, Medan, Haji Hospital Medan, Prof. Chairuddin P. Lubis USU Hospital Medan, and Putri Hijau Hospital Medan. The participants were stratified into three distinct groups: ropivacaine 0.25% (n=20), ropivacaine 0.375% (n=20), and a control group (n=20). Pain intensity was quantitatively assessed employing the numerical rating scale (NRS) at intervals of 2, 6, 12, and 24 hours postoperatively. Furthermore, the utilization of supplementary analgesics and the occurrence of adverse effects were meticulously documented. Statistical analysis of the data was conducted utilizing the Kruskal-Wallis test (p<0.05).

Results: Both ropivacaine 0.25% and 0.375% groups demonstrated significantly lower NRS pain scores at 2, 6, 12, and 24 hours postoperatively compared to the control group (p<0.05). Patients receiving ropivacaine infiltration also showed a significantly reduced need for additional analgesics compared to those who did not receive ropivacaine. However, no statistically significant differences in postoperative pain scores or supplemental analgesic requirements were observed between the 0.25% and 0.375% ropivacaine groups (p>0.05).

Conclusions: Both 0.25% and 0.375% ropivacaine effectively reduce postoperative pain and the need for additional analgesics compared to the control group. However, there was no significant difference between the two ropivacaine concentrations.

Note: This article has supplementary file(s).

Fulltext View|Download |  Graphical Abstract
Graphical Abstract_Ahmad Habibi Siregar
Subject
Type Graphical Abstract
  View (776KB)    Indexing metadata
 Research Instrument
Cover Letter
Subject
Type Research Instrument
  Download (81KB)    Indexing metadata
 Copyright Transfer Agreement
Copyright Transfer Agreement_Ahmad Habibi SIregar
Subject
Type Copyright Transfer Agreement
  Download (586KB)    Indexing metadata
 common.other
Ethical Clearance
Subject
Type Other
  Download (330KB)    Indexing metadata
Keywords: cesarean section; dosage concentration; local anesthetic; postoperative pain; ropivacain

Article Metrics:

Article Info
Section: Original Articles
Language : EN
Recent articles
Comparison of Inferior Vena Cava Distensibility Index and Pulse Pressure Variation as Predictors of Fluid Responsiveness in Sepsis Patients at the ICU Comparison of the Success of Emergency Intubation with the Heaven Score and The Lemon Score in Critically Ill Patients Who Require Mechanical Ventilation Comparison of The Efficacy of Intravenous Norepinephrine and Phenylephrine as Vasopressor Agents in The Management of Septic Shock in ICU Patients at Haji Adam Malik General Hospital Using Lactate and Stroke Volume Variation Indicators Interlaminar Cervical Epidural Non-Particulate Steroid Injection for Acute Cervical Radicular Pain: A Case Study of Clinical Effectiveness Target-Controlled Infusion (TCI) Propofol in Ventriculoperitoneal (VP) Shunt Surgery during the First Trimester of Pregnancy Anesthetic Management for Sternotomy in a Patient with Anterior Mediastinal Tumor: A Case Report Prognostic Value of the Lactate/Albumin Ratio for Mortality in Sepsis-Associated Acute Kidney Injury: A Systematic Review and Meta-Analysis More recent articles
Most cited articles
Patofisiologi Penyakit Jantung Koroner Midazolam Intravena Dosis Rendah Tidak Mempengaruhi Nitric Oxide Intraperitoneal Mencit Balb/C Yang Terpapar Lipopolisakarida More cited articles
  1. Bjørnstad J, Ræder J. Post-operative pain after caesarean section. Tidsskr Nor Laegeforen [Internet]. 2020;140(7). Available from: http://www.ncbi.nlm.nih.gov/pubmed/32378860
  2. Meissner W, Huygen F, Neugebauer EAM, Osterbrink J, Benhamou D, Betteridge N, et al. Management of acute pain in the postoperative setting: the importance of quality indicators. Curr Med Res Opin [Internet]. 2018;34(1):187–96. Available from: https://doi.org/10.1080/03007995.2017.1391081
  3. Lubis KA, Sitepu JF. Angka Kejadian Nyeri Pasca Operasi Kebidanan Di Rumah Sakit Umum Delima Medan Sumatera Utara Tahun 2020. J Kedokt Ibnu Nafis. 2021;10(2):110–5
  4. Yetneberk T, Chekol B, Teshome D. The efficacy of TAP block versus ilioinguinal block for post-cesarean section pain management: A systematic review and meta-analysis. Heliyon [Internet]. 2021;7(8):e07774. Available from: https://doi.org/10.1016/j.heliyon.2021.e07774
  5. Nguyen NK, Landais A, Barbaryan A, M’Barek MA, Benbaghdad Y, McGee K, et al. Analgesic efficacy of pfannenstiel incision infiltration with ropivacaine 7.5mg/mL for caesarean section. Anesthesiol Res Pract. 2010;2010:1–7
  6. O’Neill P, Duarte F, Ribeiro I, Centeno MJ, Moreira J. Ropivacaine continuous wound infusion versus epidural morphine for postoperative analgesia after cesarean delivery: A randomized controlled trial. Anesth Analg. 2012;114(1):179–85
  7. Saini D, Yadav U. Study of wound instillation technique for effective postoperative analgesia using ropivacaine in lumbar spine surgery. Anesth Essays Res. 2018;12(3):685
  8. Olapour A, Akhondzadeh R, Rashidi M, Gousheh M, Homayoon R. Comparing the effect of bupivacaine and ropivacaine in cesarean delivery with Spinal anesthesia. Anesthesiol Pain Med. 2020;10(1):1–6
  9. Soni DR. Comparison of the Intraperitoneal Instillation of Bupivacaine (0.25%) and Ropivacaine (0.25%) for Postoperative Analgesia in Elective Caesarean Section under Spinal Anaesthesia: A Prospective Randomised Controlled Study. J Med Sci Clin Res. 2019;7(4):1161–6
  10. Wang WB, Li YH, Sun AJ, Yu HP, Dong JC, Xu H. Bestimmung der mittleren effektiven Dosis (ED50) einer Spinalanästhesie mit Bupivacain und Ropivacain: Eine prospektive, doppelblinde, randomisierte Dosis-Wirkungs-Studie. Anaesthesist. 2017;66(12):936–43
  11. Bhardwaj S, Devgan S, Sood D, Katyal S. Comparison of local wound infiltration with ropivacaine alone or ropivacaine plus dexmedetomidine for postoperative pain relief after lower segment cesarean section. Anesth Essays Res. 2017;11(4):940
  12. Zhang L, Pang R, Zhang L. Effect of different volumes of 0.375% ropivacaine on diaphragmatic paralysis by supraclavicular brachial plexus block under ultrasound guidance. Ann Palliat Med. 2020;9(6):3993–4001
  13. Cao R, Li X, Yang J, Deng L, Cui Y. The minimum effective concentration (MEC90) of ropivacaine for ultrasound-guided quadratus lumborum block for analgesia after cesarean delivery: a dose finding study. BMC Anesthesiol [Internet]. 2022;22(1):1–8. Available from: https://doi.org/10.1186/s12871-022-01954-5
  14. TRIPATHI S, THAKRE S, NARREY N, DANDOTIYA D, SINGH P, JAIN AK. A Comparison of Post-Operative Pain Relief After Elective Lscs With Local and Intraperitoneal Ropivacaine Instillation Against Local Ropivacaine Infiltration Alone. Asian J Pharm Clin Res. 2023;16(4):18–20
  15. Abdul Jalil RM, Yahya N, Sulaiman O, Wan Mat WR, Teo R, Izaham A, et al. Comparing the effectiveness of ropivacaine 0.5% versus ropivacaine 0.2% for transabdominal plane block in providing postoperative analgesia after appendectomy. Acta Anaesthesiol Taiwanica. 2014;52(2):49–53
  16. Veronica S, Bangun CG, Hamdi T. Perbandingan derajat nyeri pada infiltrasi lokal anestesi kombinasi lidokain 1% 200 mg dan deksametason 10 mg dengan ropivakain 0,75% 150 mg terhadap luka operasi pasca seksio sesaria [Internet]. 2023. Available from: https://repositori.usu.ac.id/handle/123456789/92835
  17. Kim HJ, Lee S, Chin KJ, Kim JS, Kim H, Ro YJ, et al. Comparison of the onset time between 0.375% ropivacaine and 0.25% levobupivacaine for ultrasound-guided infraclavicular brachial plexus block: a randomized-controlled trial. Sci Rep [Internet]. 2021;11(1):1–9. Available from: https://doi.org/10.1038/s41598-021-84172-2
  18. Moya-álvarez V, Quevedo-Marín JL, Ji Z, Navarro-Jiménez C, Jiménez-García R, López-De-andrés A, et al. Variation in assignment of the COPD patients into a GOLD group according to symptom severity. Int J COPD. 2020;15:1987–95
  19. Miao F, Feng K, Feng X, Fan L, Lang Y, Duan Q, et al. The Analgesic Effect of Different Concentrations of Epidural Ropivacaine Alone or Combined With Sufentanil in Patients After Cesarean Section. Front Pharmacol. 2021;12(February):1–9
  20. Litman RS, Ambardekar A. Litman’s Basics of Pediatric Anesthesia. Elsevier; 2022
  21. Salgado-García D, Díaz-Álvarez A, González-Rodríguez JL, López-Iglesias MR, Sánchez-López E, Sánchez-Ledesma MJ, et al. Comparison of the Analgesic Efficacy between Levobupivacaine 0.25% and Ropivacaine 0.375% for PENG (Pericapsular Nerve Group) Block in the Context of Hip Fracture Surgery of Elderly Patients: A Single-Center, Randomized, and Controlled Clinical Trial. J Clin Med. 2024;13(3):1–12

Last update:

No citation recorded.

Last update: 2026-02-17 23:17:48

No citation recorded.