Ropivacaine versus Bupivacaine in Postoperative Pain Control

Abstract

Objective: The aim of this study was to compare between 2 types of long acting anesthetics: bupivacaine 0.5% and ropivacaine 0.75%, in terms of their duration of anesthesia, duration of analgesia and their effect in controlling postoperative pain after surgical removal of impacted lower third molars. Material and Methods:This study was conducted on fifty subjects referred to the Oral Surgery Department, Faculty of Dentistry, Mansoura University, for surgical removal of impacted lower third molar. Subjects were randomly assigned prior to surgery into 2 nerve block injections; the first group (group A) for an inferior alveolar nerve block (IANB) using bupivacaine and the second group (group B) for an IANB using ropivacaine. In each group, the patient's age, sex, type of impaction, severity of impaction was recorded. Time from the start of surgery till removal of impacted molar was taken as duration of surgery. Patients were instructed not to take any analgesics until numbness of lip and tongue receded.The time from onset of anaesthesia to when numbness of the lip and tongue receded as assessed by pricking is taken as the duration of anaesthesia. The time from the start of numbness to when the subject first requested a dose of oral analgesic (NSAID) was taken as duration of analgesia. Pain was assessed preoperatively and postoperatively, then patients instructed to record the extent of their pain at 3, 6, 9, and 12 hours on the day of surgery (D1), on the second (D2) and third days (D3) postoperatively. Post-operative analgesic consumption, inability to sleep because of pain, degree of overall satisfaction with the anaesthetic efficacy and postoperative pain management were considered. Results:The median duration of anaesthesia for the 7.5 mg/ml concentration of ropivacaine was approximately 6 hours, and for bupivacaine 5 mg/ml was approximately 7 hours. Bupivacaine can provide analgesia for 10.3 hours while ropivacaine can provide analgesia during the first 9.6 hours which is the period of maximum pain after third molar surgery. Conclusion:As regards a comparison of the study drugs with respect to post-operative pain experience, analgesic need and consumption, bupivacaine and ropivacaine appear to have equivalent efficacy.

A Comparative Study of Intraperitoneal Ropivacaine and Bupivacaine for Postoperative Analgesia in Laparoscopic Cholecystectomy

“…9,10 The potency of ropivacaine versus bupivacaine has been found out to be in a ratio of 3:2 according to previous studies. 9,11 Mansour et al, 12 found bupivacaine 0.5% and ropivacaine 0.75% to be equipotent in their study. Similar concentration of the drugs were used by Goldstein et al, 13 Porika et al 14 Both the groups were comparable with respect to demographic characteristics like age, gender, weight and ASA class.…”

Impact of adding opioids to paravertebral blocks in breast cancer surgery patients: A systematic review and meta-analysis

“…However, one important limitation of nerve blocks, in general, is the short duration of action of the local anesthetic. Even with agents with a longer duration of action, like bupivacaine and ropivacaine, the duration of analgesia is often inadequately sustained in the postoperative period[ 29 ]. Prolonging the duration of analgesia by increasing the dose of local anesthetic entails the risk of adverse events involving the cardiovascular and central nervous systems[ 30 ].…”

Is There a Relationship between Endotheline-1, Vascular Cell Adhesion Molecule-1 and the Arterial Hypotension Observed during Spinal Anesthesia?

“…This would be related to the voltage dependent sodium channels. Unlike ropivacaine, bupivacaine exhibits more pronounced neurological toxicity, but with equivalent efficacy to bupivacaine [58] [59] [60] [61] [62]. Thus, because of this pronounced cardiovascular effect, we preferred bupivacaine to ropivacaine.…”