No abstract

No abstract

P lain ropivacaine administered intrathecally has been shown to be feasible for ambulatory surgery of the lower extremities. Hypothetically, hyperbaric solution could improve and shorten the block.This prospective, randomized, double-blind study included 56 patients undergoing surgery of the lower extremities. They received intrathecally either 1.5 mL of ropivacaine 10 mg/mL and 0.5 mL of glucose 300 mg/mL (HYP) or 2 mL of ropivacaine 7.5 mg/mL (PL).T 10 analgesia was achieved in all patients in Group HYP, but only 64% (18/28) of Group PL achieved this level of analgesia. In the HYP group, T 10 analgesia was reached in 5 minutes (median, range 5-20 minutes) compared with 10 minutes (5-45 minutes) in the PL group (P = 0.022), and full motor block in 10 minutes (5-45 minutes) compared with 20 minutes (5-60 minutes) (P = 0.003), respectively. Group HYP had a longer duration of analgesia at T 10 (83 minutes [5-145 minutes] vs. 33 minutes [0-140 minutes]) (P = 0.004). Duration of sensory block from injection of the local anesthetic to complete recovery was briefer in Group HYP than in Group PL, 210 minutes (120-270) compared with 270 minutes (210-360 minutes) (P < 0.001). Patients of Group HYP attained discharge criteria earlier than those of Group PL (P = 0.009). The investigators concluded that 15 mg of intrathecal hyperbaric ropivacaine produced a faster onset, greater success rate of analgesia at the level of T 10 dermatome, and faster recovery of the block.

No abstract