Intrathecal anesthesia: Ropivacaine versus bupivacaine

Citation
Jm. Malinovsky et al., Intrathecal anesthesia: Ropivacaine versus bupivacaine, ANESTH ANAL, 91(6), 2000, pp. 1457-1460
Citations number
17
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Aneshtesia & Intensive Care","Medical Research Diagnosis & Treatment
Journal title
ANESTHESIA AND ANALGESIA
ISSN journal
0003-2999 → ACNP
Volume
91
Issue
6
Year of publication
2000
Pages
1457 - 1460
Database
ISI
SICI code
0003-2999(200012)91:6<1457:IARVB>2.0.ZU;2-8
Abstract
We compared intrathecal ropivacaine to bupivacaine in patients scheduled fo r transurethral resection of bladder or prostate. Doses of ropivacaine and bupivacaine were chosen according to a 3:2 ratio found robe equipotent in o rthopedic surgery. One hundred patients were randomly assigned to blindly r eceive either 10 mg of isobaric bupivacaine (0.2%, n = 50) or 15 mg of isob aric ropivacaine (0.3%, n = 50) over 30 s through a 27-gauge Quincke needle at the L2-3 level in the sitting position. Onset and offset times for sens ory and motor blockades and mean arterial blood pressure were recorded. Pai n at surgical site requiring supplemental analgesics was recorded. Cephalad spread of sensory blocks was higher with bupivacaine (median level, cold T -4 and pinprick T-7) than with ropivacaine (cold T-6 and pinprick T-9) (P < 0.001). Eight patients in Group Ropivacaine received IV alfentanil (P <0.01 ). Onset time (mean +/- SD) to T-10 anesthesia and offset time at L2 were n ot different (bupivacaine = 13 +/- 8 min, 127 +/- 41 min; ropivacaine = 11 +/- 7 min, 105 +/- 29 min). Complete motor blockade occurred in 43 patients with bupivacaine and in 41 patients with ropivacaine (not significant). To tal duration of motor blockade was not different. No difference in hemodyna mic effects was detected between groups. No patient reported back pain. We conclude that 15 mg of intrathecal ropivacaine provided similar motor and h emodynamic effects but less potent anesthesia than 10 mg of bupivacaine for endoscopic urological surgery.