Extradural ropivacaine and bupivacaine in hip surgery

Abstract

We studied 126 patients undergoing elective hip surgery; they received 20 ml of 0.5%, 0.75%, 1.0% ropivacaine or 0.5% bupivacaine extradurally in a double-blind design. Sensory block (pinprick), motor block (modified Bromage scale), quality of analgesia and neuromuscular block were assessed intermittently. Heart rate and arterial pressure were measured at regular intervals. A total of 115 patients were evaluated for efficacy. Onset of analgesia, onset of motor block and maximum cephalad spread (T4) did not differ between the groups. Duration and quality of analgesia and motor block increased with the concentration of ropivacaine. Ropivacaine 1.0% provided a longer duration of analgesia and motor block, more intense motor block and more patients with satisfactory analgesia than 0.5% bupivacaine. More patients treated with the higher concentrations of ropivacaine required treatment for hypotension and bradycardia.

Anestesia epidural com ropivacaína, lidocaína ou associação de lidocaína e xilazina em cães: efeitos cardiorrespiratório e analgésico

“…Deve-se salientar que a bradicardia pode representar efeito colateral importante em animais debilitados, apesar da ausência de hipotensão neste experimento. A lidocaína, especialmente, quando associada à adrenalina, apresenta lenta absorção sistêmica, determinando boa margem de segurança para o sistema cardiovascular, bem como a ropivacaína (WOLFF et al, 1995 adversos decorrentes do uso de ropivacaína (MARKHAM & FAULDS, 1996;PITHER et al, 2003). Embora haja relatos de que a ação (α2-adrenoceptora agonista da xilazina possa causar bradipnéia (KELAWALA et al, 1996), neste estudo, todos os parâmetros respiratórios apresentaram-se estáveis em todos os grupos.…”

“…Adicionalmente, a lidocaína é um fármaco de curta ação, sendo limitada em cirurgias prolongadas, havendo necessidade da associação com fármacos de longa duração (CRUZ et al, 1997;ISHIY et al, 2002). A ropivacaína, agente de longa duração e homóloga à bupivacaína, promove bloqueio sensitivo de duração igual ou discretamente inferior, com período de bloqueio motor e toxicidade nervosa e cardíaca menores que os daquele fármaco (WOLFF et al, 1995;FELDMAN et al, 1996).…”

A “ Comparative Study Between Bupivacaine 0.5% and Ropivacaine 0.75% in Epidural Analgesia in Patients U Ndergoing Elective Lower Abdominal and Lower Limb Surgeries ”

“…In Bupivacaine group the mean duration was 391.1± 15.1 minutes, indicating that there was no difference in the duration of sensory analgesia among the two groups. In studies conducted by Brockway M S et al 5 , Finucane B T et al 13 Katz et al 14 Wolff A.P et al 15 and Brown DL. 16 et al it was found that there was no significant difference in duration of sensory analgesia when comparing Ropivacaine with Bupivacaine.…”

“…Wolff A.P et al 15 found no difference in onset of sensory or motor block when comparing 0.5%, 0.75%, 1.0% Ropivacaine or 0.5% Bupivacaine administered extradurally in patients undergoing elective hip surgery.…”

“…Brockway M S et al 5 Finucane B T et al 15 Katz et al 16 and Wolff A.P et al 17 found the degree of motor blockade assessed by modified Bromage scale to be grade 3 in both the Ropivacaine and Bupivacaine group. This finding was similar to our study.…”