Objective: To compare postoperative analgesia after spinal anesthesia with ropivacaine + fentanyl versus ropivacaine + morphine. Methods: A prospective, randomized, observational study was conducted with a total of 64 patients undergoing emergency cesarean section. Patients were divided into two groups: group F (isobaric ropivacaine + fentanyl) and group M (isobaric ropivacaine + morphine). Clinical, demographic, and hemodynamic data were collected. Pain intensity using the Number Rating Scale (NRS) was assessed both at rest and during movement for up to 24 hours postoperatively. Adverse effects were also recorded. Results: The fall in blood pressure after anesthesia induction was greater in group F. Intraoperative pain was more frequent in group M (p = 0.015), with a mean onset time of 37.69 ± 4.42 minutes. The frequency of pruritus was significantly higher in group F; (37.50%) compared to group M (3.13%). During the first 4, 8, and 12 hours postoperatively, pain intensity both at rest and with movement was lower in group M. Conclusion: The combination of intrathecal ropivacaine and morphine demonstrated better hemodynamic stability and postoperative analgesia, with fewer adverse effects, making it an effective and safe option for spinal anesthesia in cesarean section.
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