Comparison of Bupivacaine-and Ropivacaine-Induced Conduction Blockade in the Isolated Rabbit Vagus Nerve

Bader, Angela M.; Datta, Sanjay; Flanagan, Hugh; Covino, Benjamín G.

doi:10.1213/00000539-198906000-00005

Cited by 155 publications

(58 citation statements)

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“…However, the epidural infusion of local anesthetics involves the risk of motor blockade. When compared with other local anesthetics, ropivacaine is more selective in its action on sensory fibers and it produces less motor blockade [20,21]. Etches et al [22] reported that the frequency of motor blockade caused by continuous epidural infusion of ropivacaine 21 hours after lower abdominal surgery was significantly greater with 0.2% ropivacaine at the rate of 8 to 14 mL/hr than saline, whereas there was no significant difference observed between 0.2% ropivacaine at the rate of 6 mL/hr and saline.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of intrathecal morphine with epidural ropivacaine infusion for postcesarean analgesia

Mikuni

Hirai

Toyama

et al. 2010

Journal of Clinical Anesthesia

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Section: Discussionmentioning

confidence: 99%

Efficacy of intrathecal morphine with epidural ropivacaine infusion for postcesarean analgesia

Mikuni

Hirai

Toyama

et al. 2010

Journal of Clinical Anesthesia

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“…These factors could have explained the tendency towards a more rapid block onset obtained with ropivacaine. 9,10 It might be speculated that stereospecific factors are involved in the mechanism of action of clonidine on the sodium-channels.…”

Section: Discussionmentioning

confidence: 99%

Clonidine as adjuvant for mepivacaine, ropivacaine and bupivacaine in axillary, perivascular brachial plexus block

Erlacher

Schuschnig

Koinig

et al. 2001

Can J Anesth/J Can Anesth

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Purpose: To evaluate the effects of clonidine on three local anesthetics (mepivacaine 1%, ropivacaine 0.75% and bupivacaine 0.5%) with comparable potency and almost the same concentration-response relationship.Methods: One hundred and twenty trauma-patients were randomly allocated into six groups. In the control-groups (Mo/Ro/Bo) brachial plexus was performed using 40 mL of local anesthetic plus 1 mL of NaCL 0.9%. In the clonidine-groups (Mc/Rc/Bc) brachial plexus was performed using each 40 mL of drug plus 1 mL (0.150 mg) of clonidine. Onset-time and the duration of the sensory block were recorded. Data are expressed as mean ± SD.Results: According to the average sensory block determined by a visual analog scale in the median, ulnar and radial nerve distributions and ranging from 100 (no sensory blockade) to 0 (complete sensory blockade), both mepi-groups showed a rapid onset (at 10 min: -Mo 20 ± 15 / Mc 19 ± 14; at 30 min: -Mo 3 ± 4 / Mc 5 ± 4). The ropi-and bupi-groups both had a longer onset time (at 10 min: -Ro 23 ± 19 / Rc 25 ± 22 / Bo 24 ± 15; at 30 min -Ro1 0 ± 6 / Rc11 ± 6 / Bo 12 ± 4). The onset time in group-Bc was significantly prolonged (at 10 min: -45 ± 21; at 30 min: -20 ± 6).

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“…Rosenberg and Heinonen 1 have shown, on isolated vagus nerve preparations, that ropivacaine at low concentrations was more effective in blocking A* and C-fibres than similar concentrations of bupivacaine but 16% less effective in blocking motor fibres. 2 Wildsmith et al 3 have shown, in in vitro experiments, at comparable concentrations ropivacaine is a more effective frequency-dependent blocker than bupivacaine. Thus, the ability to block the pain fibres with relative sparing of the motor fibres makes ropivacaine a suitable agent for labour epidural analgesia.…”

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confidence: 96%

Comparison of ropivacaine 0.1%-fentanyl and bupivacaine 0.125% — fentanyl infusions for epidural labour analgesia

Finegold

Mandell

Ramanathan

2000

Can J Anesth/J Can Anesth

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Purpose: To compare analgesic efficacies of ropivacaine-fentanyl and bupivacaine-fentanyl infusions for labour epidural analgesia. Methods:In this double-blind, randomized study 100, term, nulliparous women were enrolled. Lumbar epidural analgesia (LEA) was started at cervical dilatation < 5 cm using either bupivacaine 0.25% followed by bupivacaine 0.125% + 2 µg·ml -1 fentanyl infusion (n=50) or ropivacaine 0.2% followed by ropivacaine 0 .1% + 2 µg·ml -1 fentanyl infusion (n=50). Every hour maternal vital signs, visual analog scale (VAS) pain score, sensory levels, and motor block (Bromage score) were assessed. Data were expressed as mean ± 1 SD and analyzed using Chi -Squared and Mann-Whitney U tests at < 0.05. Results:The onset times were 10.62 ± 4.9 and 11.3 ± 4.7 min for the bupivacaine and ropivacaine groups respectively (P = NS). The median VAS scores were not different between the groups at any of the evaluation periods. However, at least 80% of patients in the ropivacaine group had no demonstrable motor block after the first hour compared with only 55% of patients given bupivacaine (P =0.01).Conclusions: Both bupivacaine and ropivacaine produce satisfactory labour analgesia. However, ropivacaine infusion is associated with less motor block throughout the first stage of labour and at 10 cm dilatation.Objectif : Comparer l'efficacité analgésique des perfusions de ropivacaïne-fentanyl et de bupivacaïne-fentanyl pour l'analgésie péridurale pendant le travail obstétrical.Méthode : Cent femmes nullipares et à terme ont été recrutées pour participer à une étude randomisée et à double insu. L'analgésie péridurale lombaire (APL) a été amorcée quand la dilatation cervicale était < 5 cm en utilisant soit de la bupivacaïne à 0,25 % suivie de bupivacaïne à 0,125 % + une perfusion à 2 µg·ml-1 de fentanyl (n=50), soit de la ropivacaïne à 0,2 % suivie de ropivacaïne à 0,1 % + une perfusion à 2 µg·ml-1 de fentanyl (n=50). On a noté à toutes les heures : les signes vitaux de la mère, les scores de douleur à l'échelle visuelle analogique (EVA), les niveaux sensitifs et le bloc moteur (score de Bromage). Les données ont été exprimées en termes de moyenne ± un écart type et analysées d'après le test Chi 2 et le test U de Mann-Whitney à <0,05.Résultats : Les délais d'installation ont été de 10,62 ± 4,9 et de 11,3 ± 4,7 min pour la bupivacaïne et la ropivacaïne respectivement (P = NS). Les scores moyens de l'EVA n'ont pas affiché de différence intergroupe. Cependant, au moins 80 % des patientes qui ont reçu de la ropivacaïne n'avait pas de bloc moteur vérifiable après la première heure contrairement à 55 % seulement des patientes à qui on a donné de la bupivacaïne (P =0,01).Conclusion : La bupivacaïne et la ropivacaïne produisent une analgésie satisfaisante pendant le travail obstétrical. La perfusion de ropivacaïne est toutefois associée à un bloc moteur moins intense pendant la première phase du travail et à 10 cm de dilatation.

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Comparison of Bupivacaine-and Ropivacaine-Induced Conduction Blockade in the Isolated Rabbit Vagus Nerve

Cited by 155 publications

References 0 publications

Efficacy of intrathecal morphine with epidural ropivacaine infusion for postcesarean analgesia

Efficacy of intrathecal morphine with epidural ropivacaine infusion for postcesarean analgesia

Clonidine as adjuvant for mepivacaine, ropivacaine and bupivacaine in axillary, perivascular brachial plexus block

Comparison of ropivacaine 0.1%-fentanyl and bupivacaine 0.125% — fentanyl infusions for epidural labour analgesia

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