Ropivacaine versus Lidocaine in Digital Nerve Blocks: A Prospective Study

Keramidas, Evangelos; Rodopoulou, Stavroula

doi:10.1097/01.prs.0000260725.33655.88

Cited by 39 publications

(36 citation statements)

References 25 publications

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“…The onset of analgesia after digital block with lidocaine is variable and has been reported to be as rapid as 1 minute (range, 1 to 2.7 minutes; mean 1.3 minutes) 30 and as prolonged as 10 minutes (range, 5 to 10; mean DIGITAL BLOCK ANESTHESIA 143 Evidence-Based Medicine 5.8 minutes). 31 The onset of action for bupivacaine has been reported as 11.2 minutes (range 8 to 20 minutes).…”

Section: Type Of Anestheticmentioning

confidence: 98%

Digital Block Anesthesia

Harness

2009

The Journal of Hand Surgery

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Section: Type Of Anestheticmentioning

confidence: 98%

Digital Block Anesthesia

Harness

2009

The Journal of Hand Surgery

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“…79 Although the authors did not find any evidence that long-acting LAs provide any advantages over short-acting LAs, they recommend the use of long-acting anesthetics since several studies underline its effectiveness in controlling postoperative pain. 80 The use of epinephrine added to LAs is not recommended by the authors of the review. 79 Interestingly, the comparison of local wound infiltration (LWI) with peripheral nerve block in hand lacerations did not find any difference in terms of pain and satisfaction scores, but reported a shorter anesthesia onset time for LWI, that makes this technique, easier to perform compared to nerve block, particularly attractive in the emergency department.…”

Section: Upper Limb Surgerymentioning

confidence: 99%

<p>Continuous Wound Infiltration of Local Anesthetics in Postoperative Pain Management: Safety, Efficacy and Current Perspectives</p>

Paladini

Carlo

Musella

et al. 2020

JPR

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Local infiltration and continuous infusion of surgical wound with anesthetics are parts of multimodal analgesia for postoperative pain control. The techniques, given the simplicity of execution that does not increase the timing of the intervention and does not require additional technical skills, are applied in several kinds of surgeries. The continuous wound infiltration can be used for days and a variety of continuous delivery methods can be chosen, including patientcontrolled analgesia, continuous infusion or intermittent bolus. The purpose of this narrative review is to analyze the literature, in particular by researching the safety, efficacy and current perspectives of continuous wound infiltration for postoperative pain management in different surgical settings. We have identified 203 articles and 95 of these have been taken into consideration: 17 for the lower limb surgery; 7 for the upper limb surgery, 51 for the laparotomy/ laparoscopic surgery of the abdominopelvic area, 13 studies regarding breast surgery and 7 for cardiothoracic surgery. The analysis of these studies reveals that the technique has a variable effectiveness based on the type of structure involved: it is better in structures rich in subcutaneous and connective tissue, while the effectiveness is limited in anatomic districts with a greater variability of innervation. However, regardless the heterogeneity of results, a general reduction in pain intensity and in opioid consumption has been observed with continuous wound infiltration: it is an excellent analgesic technique that can be included in the multimodal treatment of postoperative pain or represents a valid alternative when other options are contraindicated.

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“…Because of the longer effective period of ropivacaine 0.75% with an antagonistic vasodilatative effect perfusion values after 16 minutes trend to increase continuous. Effects of ropivacaine on perfusion are described controversial in the literature [14], but analysis of changes in acral blood flow showed vasodilatative effects and a long lasting effective period (6-8 hours) [12,28].…”

Section: Perfusion Evaluationmentioning

confidence: 99%

Skin perfusion and pain evaluation with different local anaesthetics in a double blind randomized study following digital nerve block anaesthesia

Schnabl

Unglaub

Leitz³

et al. 2013

Clinical Hemorheology and Microcirculation

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OBJECTIVE: Supplementing a local anaesthetic with epinephrine has advantages in hand surgery: faster onset of anaesthesia, extended effect of anaesthetics with prolonged pain reduction, decreased bleeding into the operative field, and abandoned need for tourniquet. We hypothesized that the use of ropivacaine with epinephrine additive in digits allows good skin perfusion rates with prolonged pain reduction. DESIGN: In this prospective, double-blinded, randomized study with 20 volunteers (80 fingers, without operation) the chronological course of changes in digit blood flow, post injection pain status and complication rates after two-injection dorsal technique anaesthetic block with ropivacaine (group 1: ropivacaine 0.75%, group 2: ropivacaine 0.75% and epinephrine 1 : 1.000.000, group 3: local tumescent anaesthesia 0.15% TLA: ropivacaine, lidocaine, saline solution plus epinephrine 1 : 1.000.000) were examined. As a control group, injection of 2% lidocaine in the way with 20 minutes tourniquet (group 4) was used. MAIN OUTCOME: Group 1 showed increased skin perfusion with a maximum of 160.2%, group 2 showed no significant changes with a following significant increase of skin perfusion (+66.6%). In group 3, a significant reduction (-54.1%) was followed by an increase of skin perfusion (+45.7%). In the control group (group 4) the skin perfusion was decreased (-66.2%) and increased significantly after opening the tourniquet (+248.1%). The longest pain reduction was shown for ropivacaine 0.75% and epinephrine with 18.0 hours (group 2); the other groups were between 4.6 to 8.1 hours. Conclusion: Using ropivacaine with epinephrine additive in digits could improve the intra-, and postoperative terms.

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Ropivacaine versus Lidocaine in Digital Nerve Blocks: A Prospective Study

Abstract: Ropivacaine can be used effectively as a local anesthetic for digital nerve blocks. It can be used for prolonged operations (>1.5 hours) without additional injections and can provide long-lasting postoperative analgesia.

Cited by 39 publications

References 25 publications

Digital Block Anesthesia

Digital Block Anesthesia

<p>Continuous Wound Infiltration of Local Anesthetics in Postoperative Pain Management: Safety, Efficacy and Current Perspectives</p>

Skin perfusion and pain evaluation with different local anaesthetics in a double blind randomized study following digital nerve block anaesthesia

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