Document Detail


Spinal anaesthesia for elective surgery: a comparison of hyperbaric solutions of racemic bupivacaine, levobupivacaine, and ropivacaine.
MedLine Citation:
PMID:  18765643     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The aim of this study was to compare the clinical effects of 'hyperbaric' bupivacaine for spinal anaesthesia with those of similar preparations of levobupivacaine and ropivacaine. METHODS: Sixty ASA grade I-II patients undergoing elective surgery under spinal anaesthesia were randomized to receive 3 ml of bupivacaine, levobupivacaine, or ropivacaine, each at 5 mg ml(-1) and made hyperbaric by the addition of glucose 30 mg ml(-1). A standard protocol was followed after which a blinded observer assessed the sensory and motor blocks. The level and duration of sensory (pinprick) block, intensity and duration of motor block, and time to mobilize and to micturate were also recorded. RESULTS: One patient (ropivacaine group) required general anaesthesia because of technical failure, but all the other blocks were adequate. There were no significant differences between the groups with regard to the mean time to onset of sensory block at T10, the extent of spread, or mean time to maximum spread. Regression of sensory block in the ropivacaine group was more rapid as demonstrated by duration at T10 (P<0.0167) and total duration of sensory block (P<0.0167). Patients in the ropivacaine group had more rapid recovery from motor block (P<0.0167) and shorter times to independent mobilization (P<0.0167). There were no significant differences between the bupivacaine and the levobupivacaine groups. CONCLUSIONS: 'Hyperbaric' ropivacaine provides reliable spinal anaesthesia of shorter duration than bupivacaine or levobupivacaine, both of which are clinically indistinguishable. The recovery profile of ropivacaine may be useful where prompt mobilization is required.
Authors:
J F Luck; P D W Fettes; J A W Wildsmith
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial     Date:  2008-09-02
Journal Detail:
Title:  British journal of anaesthesia     Volume:  101     ISSN:  1471-6771     ISO Abbreviation:  Br J Anaesth     Publication Date:  2008 Nov 
Date Detail:
Created Date:  2008-10-15     Completed Date:  2008-11-18     Revised Date:  2009-03-20    
Medline Journal Info:
Nlm Unique ID:  0372541     Medline TA:  Br J Anaesth     Country:  England    
Other Details:
Languages:  eng     Pagination:  705-10     Citation Subset:  IM    
Affiliation:
University Department of Anaesthesia, Ninewells Hospital and Medical School, Dundee DD19SY, UK. johnfluck@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Amides / administration & dosage,  adverse effects
Anesthesia, Spinal / adverse effects,  methods*
Anesthetics, Local / administration & dosage*,  adverse effects
Bupivacaine / administration & dosage,  adverse effects,  analogs & derivatives
Double-Blind Method
Drug Administration Schedule
Female
Humans
Male
Middle Aged
Prospective Studies
Sensation / drug effects
Specific Gravity
Surgical Procedures, Elective
Chemical
Reg. No./Substance:
0/Amides; 0/Anesthetics, Local; 0/levobupivacaine; 2180-92-9/Bupivacaine; 84057-95-4/ropivacaine
Comments/Corrections
Comment In:
Br J Anaesth. 2009 Mar;102(3):431; author reply 431   [PMID:  19218373 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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