A double-blind comparison of ropivacaine, bupivacaine, and mepivacaine during sciatic and femoral nerve blockade
| Autor: | Guido Fanelli, Andrea Casati, Federica Tarantino, P. Beccaria, Giorgio Torri, Marco Berti, Giorgio Aldegheri |
|---|---|
| Předmět: |
Adult
Male medicine.medical_specialty medicine.drug_class medicine.medical_treatment Analgesic Mepivacaine Blood Pressure Femoral nerve Heart Rate Humans Medicine Ropivacaine Anesthetics Local Aged Motor Neurons Bupivacaine Tourniquet business.industry Local anesthetic Nerve Block Middle Aged Amides Surgery Oxygen Anesthesiology and Pain Medicine Anesthesia Nerve block Female business medicine.drug |
| Zdroj: | Scopus-Elsevier |
| Popis: | No study has evaluated the efficacy of ropivacaine in peripheral nerve block of the lower extremity. The purpose of this prospective, randomized, double-blind study was to compare ropivacaine, bupivacaine, and mepivacaine during combined sciatic-femoral nerve block. Forty-five ASA physical status I or II patients scheduled for elective hallux valgus repair with thigh tourniquet were randomized to receive combined sciatic-femoral block with 0.75% ropivacaine (ROPI, n = 15), 0.5% bupivacaine (BUPI, n = 15), and 2% mepivacaine (MEPI, II = 15). Time required for onset of sensory and motor block on the operated limb (readiness for surgery) and resolution of motor block, as well as onset of postsurgical pain and time of first analgesic requirement, were recorded. The three groups were similar with regard to demographic variables, duration of surgery, and measured visual analog pain scores. Onset of sensory and motor blockade was similar in Groups ROPI and MEPI and significantly shorter than in Group BUPI (P = 0.002 and P = 0.001, respectively). Resolution of motor block occurred later in Groups ROPI and BUPI than in Group MEPI (P = 0.005 and P = 0.0001, respectively). Duration of postoperative analgesia was significantly longer in Groups ROPI (670 -C 227 min) and BUPI (880 t 312 min) compared with Group MEPI (251 + 47 min) (P = O.OOOl), with a significant decrease in postoperative pain medication requirements (P < 0.05). We conclude that for sciaticfemoral nerve block, 0.75% ropivacaine has an onset similar to that of 2% mepivacaine and a duration of postoperative analgesia between that of 0.5% bupivacame and 2% mepivacaine. Implications: Quick onset of block with prolonged postoperative analgesia is an important goal in peripheral nerve blockade. We evaluated the clinical properties of 0.5% bupivacaine, 2% mepivacaine, and 0.75% ropivacaine for sciatic-femoral nerve block and demonstrated that ropivacaine has an onset similar to that of mepivacaine but allows for postoperative analgesia between that of bupivacaine and mepivacaine. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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