Epinephrine Does Not Prolong the Analgesia of 20 mL Ropivacaine 0.5% or 0.2% in a Femoral Three-In-One Block

Weber, Anne; Fournier, Roxane; Gessel, E. Van; Riand, N.; Gamulin, Z.

doi:10.1097/00000539-200111000-00060

Cited by 73 publications

(38 citation statements)

References 14 publications

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“…Low concentrations of ropivacaine (0.063-0.5 %) injected intradermally (0.1 ml) caused vasoconstriction, but at higher concentration (1 %) did not have same effect [5,6]. Earlier studies on animals and humans have shown that addition of vasoconstrictive agent to ropivacaine did not result in any additional benefit [7]. The vasoconstrictive effect at low concentrations is likely to contribute to its duration of action in dental anesthesia, but the question of its influence on cardiovascular parameters remains as studies on volunteers and animals have reported contradictory results for the cardiovascular effect of ropivacaine [8].…”

Section: Discussionmentioning

confidence: 93%

Comparison of Ropivacaine 0.75 % and Lignocaine 2 % with 1:200,000 Adrenaline in Dental Extractions: Single Blind Clinical Trial

Bansal

Kumar

Mowar

et al. 2016

J. Maxillofac. Oral Surg.

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Section: Discussionmentioning

confidence: 93%

Comparison of Ropivacaine 0.75 % and Lignocaine 2 % with 1:200,000 Adrenaline in Dental Extractions: Single Blind Clinical Trial

Bansal

Kumar

Mowar

et al. 2016

J. Maxillofac. Oral Surg.

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“…Clonidine [114] NS at rest or on movement compared with no clonidine Adrenaline [115] NS compared with no adrenaline Ropivacaine [30,92], bupivacaine [30,92] NS Timing of administration Oral and IV conventional NSAID [10] NS pre-+ postoperative vs postoperative administration Lumbar epidural bupivacaine plus opioid [116] NS pre-+ postoperative vs postoperative administration Lumbar epidural lidocaine plus ketamine plus morphine [111] Inconclusive results pre-vs post-incision Intra-articular bupivacaine [94] NS pre-vs postoperative techniques. The systemic analgesia trials compare active intervention groups of analgesics [paracetamol, conventional non-steroidal anti-inflammatory drugs (NSAID), COX-2-selective inhibitors, weak opioids, and strong opioids] with either a control or placebo group.…”

Section: Ns Components Of Spinal Solutionmentioning

confidence: 99%

A procedure‐specific systematic review and consensus recommendations for postoperative analgesia following total knee arthroplasty

Fischer¹,

Simanski²,

Sharp³

et al. 2008

Anaesthesia

261

218

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SummaryThe PROSPECT Working Group, a collaboration of anaesthetists and surgeons, conducts systematic reviews of postoperative pain management for different surgical procedures (http://www.postoppain.org). Evidence‐based consensus recommendations for the effective management of postoperative pain are then developed from these systematic reviews, incorporating clinical practice observations, and transferable evidence from other relevant procedures. We present the results of a systematic review of pain and other outcomes following analgesic, anaesthetic and surgical interventions for total knee arthroplasty (TKA). The evidence from this review supports the use of general anaesthesia combined with a femoral nerve block for surgery and postoperative analgesia, or alternatively spinal anaesthesia with local anaesthetic plus spinal morphine. The primary technique, together with cooling and compression techniques, should be supplemented with paracetamol and conventional non‐steroidal anti‐inflammatory drugs or COX‐2‐selective inhibitors, plus intravenous strong opioids (high‐intensity pain) or weak opioids (moderate‐ to low‐intensity pain).

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“…According to our previous report where duration of analgesia with 20 mL ropivacaine 0.5% was 657 ± 345 min, 13 the sample size was computed to detect an increase of duration of 50%, i.e., 5 ½ hr with a power of 80% or greater and a 5% or less chance of a type 1 error (ß = 0.2; two-tailed α = 0.05). For four study groups a minimal sample of 18 patients per group met these criteria.…”

mentioning

confidence: 99%

“…1,2,13,16-19 Among these, only one reported the duration of analgesia of the initial dose of local anesthetic, 13 only one reported extent of the block, 16 and a dose response study has never been described previously. Our study in patients undergoing TKR demonstrates that there was no significant difference in duration of analgesia between the four anesthetic solutions studied.…”

mentioning

confidence: 99%

Duration of analgesia is similar when 15, 20, 25 and 30 mL of ropivacaine 0.5% are administered via a femoral catheter

Weber

Fournier

Riand

et al. 2005

Can J Anesth/J Can Anesth

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P Pu ur rp po os se e: : This dose-response study was designed to determine the most appropriate dose of ropivacaine 0.5% injected via an indwelling femoral catheter for perioperative peripheral analgesia for total knee replacement (TKR).M Me et th ho od ds s: : 84 patients were allocated randomly to four groups and received, via a femoral catheter, either 15, 20, 25 or 30 mL of ropivacaine 0.5% in a double-blind fashion. An anterior sciatic block with 20 mL bupivacaine 0.5% was also performed. The evolution of sensory block of femoral, obturator and lateral femoral cutaneous nerves and motor block of femoral nerve were tested every five minutes during the first 30 min. The percentage of patients with complete sensory block of both femoral and obturator nerves determined success rate. General anesthesia was then induced. After surgery, patient-controlled analgesia (PCA) with ropivacaine 0.2% was available via the femoral catheter. The interval between the initial injection and the first PCA administration determined duration of action.R Re es su ul lt ts s: : The duration of action was not different between the four solutions tested i.e., 534 ± 379 min for 15 mL, 799 ± 364 min for 20 mL, 624 ± 342 min for 25 mL and 644 ± 266 min for 30 mL. The percentage of patients with complete sensory femoral and obturator blocks was, respectively, 60%, 95%, 85% and 70% for 15, 20, 25 and 30 mL (P = 0.008/15 mL vs 20 mL).C Co on nc cl lu us si io on n: : Although there is no difference in duration of analgesia, because of better sensory spread, 20 mL of ropivacaine 0.5% appears to be the most appropriate dose for peripheral analgesia after TKR. 60 %, 95 %, 85 % et 70 % pour les doses de 15, 20, 25 et 30 mL (P = 0,008/15 mL vs20 mL Objectif

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Epinephrine Does Not Prolong the Analgesia of 20 mL Ropivacaine 0.5% or 0.2% in a Femoral Three-In-One Block

Cited by 73 publications

References 14 publications

Comparison of Ropivacaine 0.75 % and Lignocaine 2 % with 1:200,000 Adrenaline in Dental Extractions: Single Blind Clinical Trial

Comparison of Ropivacaine 0.75 % and Lignocaine 2 % with 1:200,000 Adrenaline in Dental Extractions: Single Blind Clinical Trial

A procedure‐specific systematic review and consensus recommendations for postoperative analgesia following total knee arthroplasty

Duration of analgesia is similar when 15, 20, 25 and 30 mL of ropivacaine 0.5% are administered via a femoral catheter

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