Comparison of 0.5% Ropivacaine and 0.5% Bupivacaine for Epidural Anesthesia in Patients Undergoing Lower-Extremity Surgery

Brown, David L.; Carpenter, Randall L.; Thompson, Gale E.

doi:10.1097/00000542-199004000-00010

Cited by 114 publications

(79 citation statements)

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“…Nevertheless, we noted that the motor block was profound, and the onset and duration was comparable with that of the sensory block. The relative sparing of motor block, as seen with epidural ropivacaine, 25 was not seen in this study. This may partially be explained by the higher doses used but may also reflect a differential effect on central and peripheral nerves.…”

Section: Discussioncontrasting

confidence: 73%

Clonidine prolongs the effect of ropivacaine for axillary brachial plexus blockade

2000

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Purpose: To evaluate the effect of adding clonidine to ropivacaine, for axillary brachial plexus blockade, on the onset and duration of sensory and motor block and duration of analgesia.Methods: In a prospective randomised double blind placebo controlled study axillary brachial plexus blockade was performed in 50 patients using 40 ml ropivacaine 0.75 %. Group (A) had 150 µg clonidine and Group (B) 1 ml normal saline added to the local anesthetic. Sensory function was tested using pinprick (sharp sensation, blunt sensation or no sensation) and temperature with an ice cube compared with the opposite arm, (cold/not cold). Motor function was assessed using a modified Bromage scale. Postoperative analgesia was standardised. Onset and duration of sensory and motor blockade, duration of analgesia, postoperative pain score, and analgesic requirement were compared. Results:The clonidine patients showed an increase in duration of sensory loss from 489 min to 628 min with a mean difference of 138 min (95% confidence interval of 90 to 187 min), motor blockade from 552 min to 721 min with a mean difference of 170 min (95% confidence interval of 117 to 222 min), and analgesia from 587 min to 828 min with mean difference of 241 min (95% confidence interval of 188 to 294 min). There was no difference in onset time. No side effects were noted. Conclusion:The addition of 150 µg of clonidine to ropivacaine, for brachial plexus blockade, prolongs motor and sensory block and analgesia, without an increased incidence of side effects.Objectif : Évaluer l'effet d'un ajout de clonidine à la ropivacaïne, pour le blocage du plexus brachial axillaire, sur le délai d'installation et la durée du bloc sensitif et moteur et sur la durée de l'analgésie.Méthode : Il s'agit d'une étude prospective, randomisée et à double insu contre placebo. Un blocage du plexus brachial axillaire a été réalisé chez 50 patients en utilisant 40 ml de ropivacaïne à 0,75 %. On a ajouté à l'anesthésique local, 150 µg de clonidine pour les patients du groupe A et 1 ml de solution salée pour ceux du groupe B. La fonction sensitive a été testée par piqûre d'épingle (sensation vive, légère sensation ou insensibilité) et la température par un cube de glace posé en alternance sur les deux bras (froid, non froid). La fonction motrice a été évaluée avec une échelle de Bromage modifiée. L'analgésie postopératoire a été normalisée. On a comparé le délai d'installation et la durée du blocage sensitif et moteur, la durée de l'analgésie, le score de douleur postopératoire et les besoins analgésiques.Résultats : Chez les patients qui ont reçu de la clonidine, on a noté une perte sensitive de plus longue durée, de 489 min à 628 min avec une différence moyenne de 138 min (intervalle de confiance de 95 %, de 90 à 187 min), un blocage moteur plus long de 552 min à 721 min avec une différence moyenne de 170 min (IC de 95 %, de 117 à 222 min) et une meilleure analgésie de 587 min à 828 min avec une différence moyenne de 241 min (IC de 95 %, de 188 à 294 min). Il n'y a pas eu de différen...

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Section: Discussioncontrasting

confidence: 73%

Clonidine prolongs the effect of ropivacaine for axillary brachial plexus blockade

2000

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“…Also the mean onset time of sensory block for Ropivacaine in our study was similar to the mean onset time of sensory block for Ropivacaine in a study conducted by David Brown et al, where they compared 0.5% Ropivacaine and 0.5% Bupivacaine for epidural anaesthesia (10.7± 5.6). 13 In the present study the duration of analgesia in Group LB was 229.52±11.32 minutes and in Group R was 233.48 ± 10.58 minutes. There is no statistically significant difference in the duration of analgesia between the groups.…”

Section: Sensory and Motor Parameterssupporting

confidence: 43%

The efficacy of epidural ropivacaine 0.75% and levobupivacaine 0.5% in abdominal and lower limb surgeries- a comparative study

Kumar

Rao

2016

Int J Res Med Sci

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“…However, clinical dose-finding studies have suggested a similar anaesthetic potency to bupivacaine, although with slightly different pharmacodynamic effects [7][8][9]. Higher concentrations of ropivacaine (0.5-1.0%), when given into the epidural space, have been found to provide equal sensory and motor blockade to similar concentrations of bupivacaine, but with a motor blockade of shorter duration [10][11][12][13]. However, lower concentrations (0.2%) used for obstetric epidural analgesia have been reported to have equivalent analgesic properties to similar concentrations of bupivacaine but with a lesser degree of motor block [9].…”

mentioning

confidence: 99%

A comparison of 1% ropivacaine with a mixture of 0.75% bupivacaine and 2% lignocaine for peribulbar anaesthesia

McLure¹,

Rubin²,

Westcott

et al. 1999

Anaesthesia

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SummaryIn a single centre, randomised, double-blind study, 54 patients underwent intraocular surgery under peribulbar anaesthesia with either ropivacaine 1% or a mixture of bupivacaine 0.75% and lignocaine 2%, both with hyaluronidase 7.5 iu.ml ¹1 . There were no significant differences in volume of anaesthetic required, time to onset of block, peri-operative pain scores or frequency of adverse events between the ropivacaine group and the lignocaine and bupivacaine group.

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Comparison of 0.5% Ropivacaine and 0.5% Bupivacaine for Epidural Anesthesia in Patients Undergoing Lower-Extremity Surgery

Cited by 114 publications

References 0 publications

Clonidine prolongs the effect of ropivacaine for axillary brachial plexus blockade

Clonidine prolongs the effect of ropivacaine for axillary brachial plexus blockade

The efficacy of epidural ropivacaine 0.75% and levobupivacaine 0.5% in abdominal and lower limb surgeries- a comparative study

A comparison of 1% ropivacaine with a mixture of 0.75% bupivacaine and 2% lignocaine for peribulbar anaesthesia

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