Continuous Extradural Infusion of Ropivacaine for Prevention of Postoperative Pain After Major Orthopaedic Surgery

A comparison of 0.075% and 0.15% of ropivacaine with fentanyl for postoperative patient controlled epidural analgesia after laparoscopic gynecologic surgery

“…A higher concentration of epidural ropivacaine in the group R1 may be associated with higher incidence of urinary retention due to more intense blockade. Turner et al [8] showed that approximately 10-30% of patients with epidural ropivacaine 0.2% experienced urinary retention, but another study reported that 0-1% of patients with 0.1% ropivacaine had urinary retention [4]. Nausea and vomiting, which are also common adverse effects, occurred in 25.7% of all participants, but the incidences were not significantly different between the two groups.…”

“…The optimal concentration of ropivacaine has been suggested as 2 mg/mL (0.2%) when used for epidural analgesia [2,8,9]; however, this concentration was shown to lead to excessive motor blockade and urinary retention [1,10]. Lower concentrations of ropivacaine can be helpful in minimizing motor blockade and other side effects since the concentration of local anesthetic solution is a major determinant of motor blockade with PCEA [2].…”

“…Although the action mechanism of epidural opioids is unclear, epidurally administered opioids can improve postoperative analgesia and facilitate the use of lower concentration of epidural ropivacaine with decreased motor blockade. Buggy et al reported that 0.1% ropivacaine with fentanyl provided sufficient analgesia after lower abdominal surgery [11].Their results showed that an epidural infusion of 0.1% ropivacaine plus fentanyl provided similar pain relief when compared with 0.2% ropivacaine [1,8]. In this study, we found that an epidural infusion of 0.075% ropivacaine plus fentanyl was equivalent to 0.15% ropivacaine plus fentanyl in terms of pain management after lower abdominal surgery, and both concentrations of ropivacaine provided excellent pain control (Table 2).…”

Comparison between S-ketamine and clonidine in caudal analgesia

“…The evaluation of postoperative analgesia was accomplished through the Oucher pain scale (Johnston and Wells, 1989;Ozcengiz et al, 1998), which is based on the child's expression (0 to 20: happy, 20 to 40: quiet; 40 to 60: tense/ready to cry; 60 to 80: upset/crying; 80 to 100: crying/crying with tears). Motor block was assessed by modified Bromage scale (Turner et al, 1996) (0 = no residual block; 1 = unable to raise extended legs; 2 = unable to flex knees; 3 = unable to flex the ankles). The parents were instructed about the use of pain scoring system during the preoperative visit.…”

An Economic Evaluation of Bupivacaine Plus Fentanyl Versus Ropivacaine Alone for Patient-Controlled Epidural Analgesia After Total-Knee Replacement Procedure: A Double-Blinded Randomized Study

“…Ropivacaine may have some properties superior to bupivacaine. 1 Turner et al 2 and Etches et al 3 found that 0.2% ropivacaine, at a rate of 8 mL/h or more, is required to provide good analgesia. However, infusion at this concentration and rate may be associated with an increased incidence of motor block and urinary retention.…”