Ropivacain zur Spinalan�sthesie Eine Dosisfindungsstudie

Wahedi, W; Nolte, Hans; Klein, peggy W.

doi:10.1007/s001010050306

Cited by 60 publications

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“…7,13 Maximum level of sensory blockade was found to be T10 in group A and T8 in group B and this difference was found to be statistically significant. Because isobaric solutions were used for the study the level remained restricted to lower segments and these findings were consistent with findings of Van Kleef et al, Wahedi et al 9,12 Complete motor blockade was obtained in 80% patients in group A as compared to 96% in group B in our study. Gautier et al had similar results and concluded that the degree of motor blockade increases with the increase in the dose of ropivacaine.…”

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confidence: 92%

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A prospective, comparative, observational study of quality of spinal anaesthesia with 0.5% and 0.75% plain isobaric ropivacaine in lower abdomen and lower limb surgeries

Gupta

Amilkanthwar

2016

Int J Res Med Sci

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INTRODUCTIONSpinal anaesthesia or subarachnoid block remains one of the basic techniques in the arsenal of modern anaesthesiology. The spinal anaesthesia has the potential for being uniquely safe anaesthetic technique due to the combination of profound analgesia, muscle relaxation and less systemic and metabolic disturbances. Preservation of airway, decrease blood loss and ability to provide residual postoperative analgesia are further advantages.1 Spinal or intrathecal anaesthesia has a long history of success and is more popular, mostly due to an increasing number of ambulatory procedures and interventions, for which the ideal spinal anaesthetic would provide rapid and adequate surgical anaesthesia together with early ambulation to allow early discharge.Bupivacaine is extensively used and produces an adequate sensory and motor blockade.2 Although intrathecal bupivacaine has low incidence of ABSTRACT Background: Spinal anaesthesia or subarachnoid block remains one of the basic techniques in the arsenal of modern anaesthesiology. Aim of the study was to evaluate and compare quality of spinal anaesthesia with isobaric 0.5% and 0.75% intrathecal ropivacaine in patients undergoing lower abdominal and lower limb surgeries. Methods: 100 patients between 18 and 60 years, of either gender belonging to ASA class I or II, posted for elective lower abdominal and lower limb surgeries, planned under spinal anaesthesia using ropivacaine. Patients were grouped as group A: 3 ml (15 mg) of 0.5% plain ropivacaine and Group B: 3ml (22.5mg) of 0.75% plain ropivacaine. Parameters observed were onset and duration of sensory and motor block, maximum sensory level achieved degree of motor blockade, two segment regression, and haemodynamic changes. Results: No significant differences were noted in Mean time for onset and time to achieve maximum level of sensory and motor blockade in both groups. Maximal dermatomal level was T10 in group A and T8 in group B which was statistically significant. Also, 96% patients had grade III motor blockade in group B as compared to 80% in group A which was statistically significant. Significant differences were noted in Time for two segment regression (92.56±11.846 minutes in group A and 137.3±13.06 min in group B), the duration of sensory blockade (184.5±18.385 min in group A and 238.8±19.260 min in group B) and duration of motor blockade (120.3±15.59 min in group A and 178.8±16.053 min in group B). Conclusions: Intrathecal isobaric ropivacaine 0.5% and 0.75% are safe and effective with minimal intraoperative and postoperative side effects. Recommended for short duration orthopaedic and lower abdominal surgeries where prolonged motor blockade is undesirable.

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confidence: 92%

“…Similar findings were noted by Van Kleef et al, Wahedi et al 9,12 Also, the time taken to achieve maximum sensory and motor blockade was similar in both groups. Rajani Gupta et al and Radhika rani et al had noted similar findings in their study.…”

supporting

confidence: 89%

A prospective, comparative, observational study of quality of spinal anaesthesia with 0.5% and 0.75% plain isobaric ropivacaine in lower abdomen and lower limb surgeries

Gupta

Amilkanthwar

2016

Int J Res Med Sci

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“…This provides a useful guide for clinicians to choose the optimal dose of spinal ropivacaine under different clinical situations. 11 Fettes et al 12 provided further evidence that a dose of 15 mg hyperbaric ropivacaine produces predictable and Note: *p-value < 0.05. There was a statistically significant difference in time to requirement of first analgesic among the three groups (p = 0.002).…”

Section: Discussionmentioning

confidence: 99%

“…Kallio and colleagues 8 found that ropivacaine 15 mg provided a faster recovery of motor block, but a similar duration of sensory block to bupivacaine 10 mg. Wahedi et al 11 reported that loss of sensation at the T10 dermatome was achieved with 15 mg of ropivacaine, which prompted the use of this dose. The ED 50 and ED 95 for spinal ropivacaine in lower limb surgery of 50 minutes' duration or less have been found to be 7.6 and 11.4 mg, respectively.…”

Section: Discussionmentioning

confidence: 99%

A randomised trial to compare the effect of addition of clonidine or fentanyl to hyperbaric ropivacaine for spinal anaesthesia for knee arthroscopy

Bathari

Bhalotra

Anand

et al. 2015

Southern African Journal of Anaesthesia and Analgesia

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Objectives:To evaluate the clinical effects of hyperbaric ropivacaine alone and with clonidine or fentanyl for spinal anaesthesia for knee arthroscopy. Methods: Sixty ASA I/II patients were randomised to receive spinal anaesthesia with hyperbaric ropivacaine alone (Group R), or with clonidine 15 μg (Group RC) or fentanyl 30 μg (Group RF). The sensory and motor block, time to micturition and side effects were assessed. Results:The three groups were similar in mean time to onset of sensory block at T10, height of block and time to maximum block. Sensory regression to S2 took longer in Groups RF and RC compared with Group R (p = 0.001 and p < 0.01, respectively). Time to requirement of rescue analgesia was longer in Groups RF and RC compared with Group R (p = 0.023 and 0.002, respectively). Time for complete regression of motor block and time to voiding were longer in group RC compared with group R (p = 0.022 and p = 0.013, respectively). Conclusion:The addition of fentanyl 30 μg to hyperbaric ropivacaine may be superior to the addition of clonidine 15 μg for knee arthroscopy as it provides a similar prolongation of sensory block and analgesia without prolonging motor block and time to micturition.

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“…30 The choice of a 12 mg dose for the 0.4% ropivacaine group was in accordance with results of different dose-finding studies. 22,31,32 For prilocaine, the dose of 60 mg was chosen in accordance with the results of a study by Camponovo et al Their study results showed that 13% of patients receiving 40 mg of intrathecal hyperbaric 2% prilocaine and none of the patients receiving 60 mg of plain prilocaine needed supplementary analgesics prior to the end of surgery. 33 The discharge time of patients in the plain ropivacaine group was in accordance with other studies comparing plain ropivacaine with hyperbaric ropivacaine at doses up to 15 mg. [34][35][36][37] Nevertheless, it is difficult to compare sensory or motor recovery due to a number of differences between the various studies, including study design, injection techniques (median, paramedian, slow injection, needle orifice facing up or toward the patient's head/toe), 11,33 needles (25-27G), 33,38 location of lumbar space (L1/L2 -L4/L5), 38,39 patient management after injection (immediate turning to supine position or remaining in the lateral position for a longer period), [38][39][40] and motor scales (Bromage, modified Bromage scale).…”

Section: Discussionmentioning

confidence: 99%

Intrathecal hyperbaric 2% prilocaine versus 0.4% plain ropivacaine for same-day arthroscopic knee surgery: a prospective randomized double-blind controlled study

Aguirre

Borgeat

Bühler

et al. 2015

Can J Anesth/J Can Anesth

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Intrathecal hyperbaric 2% prilocaine versus 0.4% plain ropivacaine for same-day arthroscopic knee surgery: a prospective randomized double-blind controlled study Prilocaïne 2 % hyperbare versus ropivacaïne 0,4 % en injection intrathécale pour une arthroscopie du genou en chirurgie ambulatoire: une étude randomisée contrôlée prospective à double insu AbstractBackground Short-duration spinal anesthesia is a good option for ambulatory knee surgery. Hyperbaric 2% prilocaine has short onset and rapid recovery times and, therefore, may be well suited in this setting. The aim of this study was to compare the times to reach motor block, motor block resolution, and discharge from the postanesthesia care unit (PACU) between hyperbaric 2% prilocaine and 0.4% plain ropivacaine.Methods In this prospective randomized double-blind study, 140 patients (ages 18-80 yr and American Society of Anesthesiologists physical status I-II) scheduled for elective unilateral arthroscopic knee surgery lasting \ 45 min were allocated to either 3 mL of 2% prilocaine (60 mg) or 3 mL of 0.4% plain ropivacaine (12 mg). Time to reach complete recovery of motor block, time to reach criteria for discharge, as well as side effects up to 48 hr after discharge were recorded. Results The median (interquartile range [IQR]) time to recovery from the motor block was faster in the 2% prilocaine group compared with the 0.4% ropivacaine group (180 [169-240] min vs 240 [180-300] min, respectively; median difference, 60 min, 95% confidence interval (CI), 23 to 97 min; P = 0.036). The median [IQR] time to reach discharge criteria was similar between the two groups (330 min vs, 335 [290-395] min; median difference 5 min, 95% CI, -25 to 35 min; P = 0.330). The incidence of side effects was low and similar in both groups. No case of transient neurologic symptoms occurred in either group. Conclusion The recovery of motor block was faster after intrathecal administration of hyperbaric 2% prilocaine compared with 0.4% plain ropivacaine; however, discharge time was similar between the two groups. Both drugs showed a similar risk profile. RésuméContexte La rachianesthésie de courte durée est une bonne option lorsqu'on pratique une chirurgie ambulatoire du genou. Le délai d'action de la prilocaïne 2 % hyperbare est court et son temps de récupération rapide; cet agent

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Ropivacain zur Spinalan�sthesie Eine Dosisfindungsstudie

Abstract: At concentrations of 0.5% and 0.75%, ropivacaine results in long-lasting spinal anaesthesia. (A

Cited by 60 publications

References 0 publications

A prospective, comparative, observational study of quality of spinal anaesthesia with 0.5% and 0.75% plain isobaric ropivacaine in lower abdomen and lower limb surgeries

A prospective, comparative, observational study of quality of spinal anaesthesia with 0.5% and 0.75% plain isobaric ropivacaine in lower abdomen and lower limb surgeries

A randomised trial to compare the effect of addition of clonidine or fentanyl to hyperbaric ropivacaine for spinal anaesthesia for knee arthroscopy

Intrathecal hyperbaric 2% prilocaine versus 0.4% plain ropivacaine for same-day arthroscopic knee surgery: a prospective randomized double-blind controlled study

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