Comparison of ropivacaine 0.2% and 0.25% with lidocaine 0.5% for intravenous regional anesthesia

Asik, Ibrahim; Kocum, Aysu; Göktuğ, Asutay; Turhan, Keziban Sanem Çakar; Alkış, Neslihan

doi:10.1016/j.jclinane.2008.10.011

Cited by 26 publications

(29 citation statements)

References 24 publications

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“…Ropivacaine is highly protein bound, resulting in a slower systemic release and longer sensory blockade after the tourniquet is released. 8,13 In our study, the absence of CNS adverse effects after tourniquet release might have been due to a relatively long period of tourniquet inflation.…”

Section: Discussionmentioning

confidence: 60%

“…13 In addition, the studies of Asik et al 13 demonstrated longer tourniquet tolerance with a higher concentration of anesthetic solution. Since Rousso et al 14 reported efficient IVRA with a forearm tourniquet, several more recent studies have used a reduced volume of local anesthetic with the theoretical advantage of reduced risk of systemic toxicity in the event of tourniquet failure.…”

Section: Discussionmentioning

confidence: 97%

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Progression of Forearm Intravenous Regional Anesthesia With Ropivacaine

Horn¹,

Cordo

Künster

et al. 2011

Regional Anesthesia and Pain Medicine

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The progression of sensory blockade in the hand following a forearm Bier block with ropivacaine is currently unknown. The hands of 10 healthy adult human subjects were anesthetized with ropivacaine, and their sensitivities to cold and touch were tested until the completion of anesthesia. On average, insensitivity to cold occurred uniformly throughout the hand within 9 mins; however, touch sensation was not complete until approximately 20 mins after injection. The spread of anesthesia occurred in a semisystematic way, spreading proximally and distally from the site of injection (mid-dorsum of the hand), and, at a slower rate, from the dorsum of the hand to the palm.

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Section: Discussionmentioning

confidence: 60%

Section: Discussionmentioning

confidence: 97%

Progression of Forearm Intravenous Regional Anesthesia With Ropivacaine

Horn¹,

Cordo

Künster

et al. 2011

Regional Anesthesia and Pain Medicine

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“…Overall, there were no significant differences in the onset of sensory block between lidocaine, prilocaine, and ropivacaine 8,26–29,31,32. One study15 compared 0.5% prilocaine with 0.2% ropivacaine and found that more patients had pin-prick analgesia in one of the four peripheral nerve distributions (radial nerve) 10 minutes after injection in the prilocaine group compared to the ropivacaine group (90% vs 60%).…”

Section: Resultsmentioning

confidence: 99%

“…8,15,26–32 One study evaluated three different LA drugs,32 with the remaining studies evaluating two LA agents in comparison to one another. Three of the studies reported sample size estimations and power analysis 15,26,30. Allocation concealment was adequate in two studies30,32 and unclear in the others (Table 1).…”

Section: Resultsmentioning

confidence: 99%

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Intravenous regional anesthesia: a review of common local anesthetic options and the use of opioids and muscle relaxants as adjuncts

Flamer

Peng²

2011

LRA

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PurposeTo provide a review of local anesthetic (LA) agents and adjuncts, opioids and muscle relaxants, and their intraoperative effects and postoperative outcomes in intravenous regional anesthesia (IVRA).SourceA search for prospective, double-blind, randomized controlled trials evaluating LA agents, opioids and muscle relaxants as adjuvants for IVRA, was conducted (MEDLINE®, Embase). Intraoperative benefits (onset/recovery of sensory and motor block, intraoperative analgesia, tourniquet pain), postoperative benefits (pain score, analgesic consumption, time to first analgesia), and side effects were recorded. A conclusion for overall benefit was made based on statistical significance and clinical relevance.FindingsThirty-one studies were evaluated, with data collected on 1523 subjects. LA agents evaluated were lidocaine, ropivacaine, and prilocaine. Adjuncts evaluated were opioids ( morphine, fentanyl, meperidine, sufentanil, tramadol) and muscle relaxants (pancuronium, atracurium, mivacurium, cisatacurium). There was good evidence that ropivacaine provided effective IVRA and improved postoperative analgesia. Lidocaine and prilocaine were effective LA agents, however they lacked postoperative benefits. Morphine, fentanyl, and meperidine as sole adjuncts did not demonstrate clinically significant benefits or result in an increased risk of side effects. Sufentanil data was limited, but appeared to provide faster onset of sensory block. Tramadol provided faster onset of sensory block and tourniquet tolerance, however postoperative benefits were not consistent and the risk of minor side effects increased. Muscle relaxants improved the quality of motor block, but at the expense of delayed motor recovery. The combination of fentanyl and muscle relaxants can achieve an equivalent quality of IVRA with 50% reduction in LA dose, but at the expense of a potentially slower onset of sensory block.ConclusionRopivacaine is effective for IVRA and improves postoperative analgesia. Muscle relaxants enhance the motor block and when combined with fentanyl allow for an equivalent quality of IVRA with 50% reduction in LA dose.

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Intravenous Regional Anesthesia

Staffieri¹

2013

Small Animal Regional Anesthesia and Analgesia

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Comparison of ropivacaine 0.2% and 0.25% with lidocaine 0.5% for intravenous regional anesthesia

Cited by 26 publications

References 24 publications

Progression of Forearm Intravenous Regional Anesthesia With Ropivacaine

Progression of Forearm Intravenous Regional Anesthesia With Ropivacaine

Intravenous regional anesthesia: a review of common local anesthetic options and the use of opioids and muscle relaxants as adjuncts

Intravenous Regional Anesthesia

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