Comparison between intrathecal hyperbaric bupivacaine and levobupivacaine for ambulatory knee arthroscopy

Sağır, Özlem; Özaslan, Sabri; Erduran, Mehmet; Meriç, Yücel; Aslan, İsmail; Köroğlu, Ahmet

doi:10.5313/wja.v2.i3.18

Cited by 6 publications

(5 citation statements)

References 17 publications

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“…31,32 Spinal anesthesia with bupivacaine or ropivacaine has been widely used for knee arthroscopy. 21 Ropivacaine has the features of better hemodynamic profile and shorter duration of the motor block, which facilitates early mobilization in the postoperative ward. 33 In one RCT involving day care knee arthroscopy, intrathecal isobaric ropivacaine results in a longer onset, shorter duration of sensory, and motor block and lesser degree of the motor block as compared with bupivacaine but requires increased analgesics.…”

Section: Discussionmentioning

confidence: 99%

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The Comparison of Intrathecal Ropivacaine with Bupivacaine for Knee Arthroscopy: A Meta-analysis of Randomized Controlled Trials

et al. 2020

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The comparison of intrathecal ropivacaine with bupivacaine for knee arthroscopy remains controversial. We conduct a systematic review and meta-analysis to explore the efficacy of intrathecal ropivacaine versus bupivacaine for knee arthroscopy. We search PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through August 2019 for randomized controlled trials (RCTs) assessing the effect of intrathecal ropivacaine versus bupivacaine for knee arthroscopy. This meta-analysis is performed using the random effects model. Five RCTs are included in the meta-analysis. Overall, compared with intrathecal bupivacaine for knee arthroscopy, intrathecal ropivacaine is associated with increased onset time of motor block (mean difference [MD] = 2.05, 95% CI: 1.43–2.67, p < 0.00001) and decreased duration of sensory block (MD = −26.82, 95% CI: −31.96 to −21.67, p < 0.00001) but shows no remarkable influence on onset time of sensory block (MD = −0.09; 95% CI: −1.89 to 1.70, p = 0.92), duration of motor block (MD = −59.76; 95% CI: −124.44 to 4.91, p = 0.07), time to maximum block (MD = 2.35; 95% CI: –0.16 to 4.86, p = 0.07), first urination time (MD = −26.42, 95% CI: −57.34 to 4.51, p = 0.09), or first ambulation time (MD = 3.63, 95% CI: −25.20 to 32.47, p = 0.80).Intrathecal ropivacaine can substantially increase onset time of motor block and decrease the duration of sensory block than intrathecal bupivacaine for knee arthroscopy.

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Section: Discussionmentioning

confidence: 99%

“…20 Bupivacaine and ropivacaine are both widely used for the knee arthroscopic surgery. 21 The efficacy of ropivacaine versus bupivacaine for knee arthroscopic surgery has not been well established. Recently, several studies on the topic have been published, and the results have been conflicting.…”

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confidence: 99%

The Comparison of Intrathecal Ropivacaine with Bupivacaine for Knee Arthroscopy: A Meta-analysis of Randomized Controlled Trials

et al. 2020

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“…Bupivacaine and ropivacaine have been widely used for this purpose, as have other newer local anesthetic agents like levobupivacaine. [ 5 ] Due to its better hemodynamic profile and shorter duration of the motor block, ropivacaine enables early mobilization in the postoperative ward, a fact which makes it suitable for shorter procedures conducted in daycare settings. [ 6 ]…”

Section: Discussionmentioning

confidence: 99%

Comparison of the efficacy of intrathecal isobaric ropivacaine and bupivacaine in day care knee arthroscopy: A randomized controlled trial

Kumar

Talwar²,

Gupta

et al. 2018

Anesth Essays Res

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“…3 Spinal anaesthesia is often preferred for arthroscopic knee surgery, because of the procedure's low level of difficulty, reduced incidence of nausea or vomiting, but the duration of postoperative analgesia is not prolonged by spinal anaesthesia when given only with local anaesthetic like bupivacaine. 4 During spinal anaesthesia, the addition of intrathecal opioids like fentanyl allows the use of less local anaesthetic, provides analgesia in the postoperative period, but may cause sideeffects like urinary retention, pruritus, nausea and vomiting. 2 Thus, intra-articular drug administration at the end of surgery can be used as a strategy for management of postoperative pain after arthroscopic knee surgeries performed under spinal anaesthesia.…”

Section: B a C K G R O U N Dmentioning

confidence: 99%

Effectiveness of Intra-Articular Ropivacaine for Post-Operative Analgesia in Arthroscopic Knee Surgeries

Nagpure¹,

Modak²,

Singam³

et al. 2020

jemds

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BACKGROUNDPost-operative pain frequently hampers implementation of day care arthroscopic knee surgery in spite of so many analgesic, local anaesthetic drugs and routes of administration. The aim of this study was to evaluate the efficacy and safety of intraarticularly administered inj. ropivacaine 0.25% 20 ml, after arthroscopic knee surgery performed under spinal anaesthesia, for prolonging the duration of postoperative analgesia. METHODSThis is a prospective randomized study conducted among 80 patients of both sexes, of American Society of Anesthesiologists, physical status I and II, undergoing day care arthroscopic knee surgery who were randomly assigned into two groups (R, C). Group R received 20 ml of 0.25% ropivacaine, whereas group C received 20 ml of 0.9% inj. normal saline through intra-articular route at the end of the procedure. Pain was assessed using visual analog scale (VAS) and paracetamol given as rescue analgesic when VAS >4. Time of first analgesic request and total rescue analgesic were noted. RESULTSTime for the requirement of first post-operative rescue analgesia (255.15±26.35 vs. 92.40±12.54) min and total mean rescue analgesic requirement was (1.32±0.52 vs. 3.0±1.0) in group R and C respectively. Group C had higher mean VAS score throughout the study period. No side effects were found among the groups. These two results were clinically and statistically significant (p<0.05). CONCLUSIONSAdministration of intra-articular inj. ropivacaine 0.25%, 20ml, is effective & safe method of management of postoperative pain in patients undergoing arthroscopic knee surgeries, as it prolongs the duration of postoperative analgesia, provides better quality of analgesia with reduced requirement of rescue analgesia without significant side effects.

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Comparison between intrathecal hyperbaric bupivacaine and levobupivacaine for ambulatory knee arthroscopy

Cited by 6 publications

References 17 publications

The Comparison of Intrathecal Ropivacaine with Bupivacaine for Knee Arthroscopy: A Meta-analysis of Randomized Controlled Trials

The Comparison of Intrathecal Ropivacaine with Bupivacaine for Knee Arthroscopy: A Meta-analysis of Randomized Controlled Trials

Comparison of the efficacy of intrathecal isobaric ropivacaine and bupivacaine in day care knee arthroscopy: A randomized controlled trial

Effectiveness of Intra-Articular Ropivacaine for Post-Operative Analgesia in Arthroscopic Knee Surgeries

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