Intrathecal ropivacaine for total hip arthroplasty: double-blind comparative study with isobaric 7.5 mg ml −1 and 10 mg ml −1 solutions

Abstract

This study was designed to evaluate the efficacy and safety of two concentrations of intrathecal ropivacaine, 7.5 and 10 mg ml(-1), in patients undergoing total hip arthroplasty. One hundred and four patients, ASA I-III, were randomized to receive an intrathecal injection of one of two concentrations of isobaric ropivacaine. Group 1 (n=51) received 2.5 ml of 7.5 mg ml(-1) ropivacaine (18.75 mg). Group 2 (n=53) received 2.5 ml of 10 mg ml(-1) ropivacaine (25 mg). The onset and offset of sensory block at dermatome level T10, maximum upper and lower spread of sensory block and the onset, intensity and duration of motor block were recorded, as were safety data. Onset of motor and sensory block was rapid with no significant differences between the two groups. The median time of onset of sensory block at the T10 dermatome was 2 min (range 1-25 min) in Group 1 and 2 min (range 1-21 min) in Group 2. The median duration of sensory block at the T10 dermatome was 3.0 h (range 0.5-4.2 h) in Group 1 and 3.4 h (1.1-5.9 h) in Group 2 (P=0.002). The median duration of complete motor block was significantly prolonged (P<0.05) in Group 2 compared with Group 1 (1.9 vs 1.2 h, respectively). Anaesthetic conditions were excellent in all but one patient. Intrathecal ropivacaine, in doses of 18.75 and 25 mg, was well tolerated and provided effective anaesthesia for total hip arthroplasty.

Comparative Evaluation of Haemodynamic Changes and Complications Associated With Two Different Doses of Ropivacaine Hydrochloride (0.75% and 0.5%) in Spinal Anaesthesia in Lower Limb Orthopaedic Surgeries

“…Tramadol. Our study was in accordance with various studies, [16,17] who also found insignificant changes with respect to nausea and vomiting. There was no case of local anaesthetic toxicity, pruritus or total spinal in both the groups.…”

“…In terms of safety, both doses of intrathecal ropivacaine provided high degree of cardiovascular stability with a low incidence of bradycardia and hypotension. The results correspond with other studies, [16,17,18] in which it was found that there was high degree of cardiovascular safety and there was no difference in various groups receiving different doses of ropivacaine.…”

“…It was statistically insignificant, which was well in accordance with the various studies found in literature. [16,17,18] In our study, only 5 patients out of 80 patients had post dural puncture headache, which was managed with intravenous fluids and a non-steroidal anti-inflammatory drug. It was in accordance with the study done by Wahedi et al, in which 12 out of 40 patients had post dural puncture headache and was statistically insignificant.…”

A Comparative Study of Intrathecal Isobaric Ropivacaine with Different Doses of Clonidine in Lower Extremity Surgery

“…Our results were similar to studies of McNamee et al and Van Kleef et al with regards to time taken to achieve maximum motor block and duration of motor block [9], [10] . Result of this study also coincide with Gonul Sagiroglu et al as in their study the isobaric ropivacaine group showed a more rapid recovery from motor block compared with the ropivacaineclonidine groups [7] .…”

Intrathecal hyperbaric 2% prilocaine versus 0.4% plain ropivacaine for same-day arthroscopic knee surgery: a prospective randomized double-blind controlled study

“…30 The choice of a 12 mg dose for the 0.4% ropivacaine group was in accordance with results of different dose-finding studies. 22,31,32 For prilocaine, the dose of 60 mg was chosen in accordance with the results of a study by Camponovo et al Their study results showed that 13% of patients receiving 40 mg of intrathecal hyperbaric 2% prilocaine and none of the patients receiving 60 mg of plain prilocaine needed supplementary analgesics prior to the end of surgery. 33 The discharge time of patients in the plain ropivacaine group was in accordance with other studies comparing plain ropivacaine with hyperbaric ropivacaine at doses up to 15 mg. [34][35][36][37] Nevertheless, it is difficult to compare sensory or motor recovery due to a number of differences between the various studies, including study design, injection techniques (median, paramedian, slow injection, needle orifice facing up or toward the patient's head/toe), 11,33 needles (25-27G), 33,38 location of lumbar space (L1/L2 -L4/L5), 38,39 patient management after injection (immediate turning to supine position or remaining in the lateral position for a longer period), [38][39][40] and motor scales (Bromage, modified Bromage scale).…”