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Background <p>Spinal anesthesia is commonly used in outpatient total hip arthroplasty (THA). Optimizing the duration of sensory and motor blocks is critical for early postoperative recovery.</p> Objective <p>This study aimed to compare the duration of motor block and post-anesthesia care unit (PACU) stay between intrathecal bupivacaine and ropivacaine in patients undergoing outpatient THA.</p> Methods <p>A total of 220 ASA I–II patients scheduled for outpatient THA were retrospectively analyzed. Of these, 110 patients received 12–14&#xa0;mg of intrathecal bupivacaine, and 110 patients received 14–16&#xa0;mg of intrathecal ropivacaine. The primary outcomes were the duration of motor block and the length of PACU stay, and secondary outcomes included time to discharge and postoperative complications.</p> Results <p>The mean (SD) dose of spinal anesthetic was 14.9 (0.7) mg in the ropivacaine group and 12.6 (0.8) mg in the bupivacaine group. Ropivacaine was associated with a significantly shorter duration of motor block (mean difference 44.9&#xa0;min; 95% CI 33.2–56.6; <i>P</i> &lt; 0.001), PACU stay (median difference 12.3&#xa0;min; 95% CI 2.1–22.6; <i>P</i> = 0.019), and time to first postoperative void (mean difference 0.6&#xa0;h; 95% CI 0.1–1.0; <i>P</i> = 0.009). Ropivacaine provided more predictable motor block duration than bupivacaine (<i>P</i> &lt; 0.001), with similar variability in PACU time. No significant between-group differences were observed in discharge time or postoperative complications.</p> Conclusion <p>Intrathecal ropivacaine provides a shorter motor block duration and faster early recovery compared with bupivacaine in outpatient THA, without increasing postoperative complications, but confirmation in a well-designed prospective study is warranted.</p>

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Anesthetic recovery profiles of intrathecal ropivacaine and bupivacaine in ASA I–II patients undergoing outpatient total hip arthroplasty

  • 期刊论文

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  • 发表日期：

    2026年6月3日

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  • Maarit Rantakokko,
  • Marcus Teräs,
  • Matias Hemmilä,
  • Otso Kinnunen,
  • Mikael Helenius,
  • Panu Uusalo

摘要

Background

Spinal anesthesia is commonly used in outpatient total hip arthroplasty (THA). Optimizing the duration of sensory and motor blocks is critical for early postoperative recovery.

Objective

This study aimed to compare the duration of motor block and post-anesthesia care unit (PACU) stay between intrathecal bupivacaine and ropivacaine in patients undergoing outpatient THA.

Methods

A total of 220 ASA I–II patients scheduled for outpatient THA were retrospectively analyzed. Of these, 110 patients received 12–14 mg of intrathecal bupivacaine, and 110 patients received 14–16 mg of intrathecal ropivacaine. The primary outcomes were the duration of motor block and the length of PACU stay, and secondary outcomes included time to discharge and postoperative complications.

Results

The mean (SD) dose of spinal anesthetic was 14.9 (0.7) mg in the ropivacaine group and 12.6 (0.8) mg in the bupivacaine group. Ropivacaine was associated with a significantly shorter duration of motor block (mean difference 44.9 min; 95% CI 33.2–56.6; P < 0.001), PACU stay (median difference 12.3 min; 95% CI 2.1–22.6; P = 0.019), and time to first postoperative void (mean difference 0.6 h; 95% CI 0.1–1.0; P = 0.009). Ropivacaine provided more predictable motor block duration than bupivacaine (P < 0.001), with similar variability in PACU time. No significant between-group differences were observed in discharge time or postoperative complications.

Conclusion

Intrathecal ropivacaine provides a shorter motor block duration and faster early recovery compared with bupivacaine in outpatient THA, without increasing postoperative complications, but confirmation in a well-designed prospective study is warranted.