Ropivacaine vs. levobupivacaine combined with sufentanil for epidural analgesia after lung surgery

Cosmo, Germano De; Congedo, Elisabetta; Lai, Carlo; Sgreccia, Marina; Amato, Antonino; Beccia, G.; Aceto, Paola

doi:10.1017/s0265021508004638

Cited by 22 publications

(7 citation statements)

References 22 publications

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“…The recommended doses of propofol for induction dose(ID) and maintenance dose(MD)of anesthesia are 1-2.5 mg/kg and 50-150 μg/kg/min, respectively. [19,22,29,30] In this study, IDs of both groups for propofol OCTOBER 2015 176 PAIN A RI were established compatible with these mentioned limits. However propofol ID was found significantly low in group E. Besides, propofol anesthesia MDs in group C was established in mentioned limits but found significantly higher than that in group E. In Group E, propofol MD was found to be significantly lower than recommended dose interval.…”

Section: Discussionsupporting

confidence: 65%

“…[8][9][10] TIVA is well documented with regard to effect, tolerability and safety. [11][12][13][14] Combination of epidural and general anesthesia is proposed to be associated with more rapid recovery, [15,16] reduced blood loss, [17] reduced risk of venous thrombosis, [18] early mobilization of the patient [19,20] and shortened stay in intensive care units. [19,21,22] The bispectral index score (BIS) has been proven to correlate well with the hypnotic state of the patient during both inhaled and IV anesthesia.…”

Section: Introductionmentioning

confidence: 99%

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Effects of Combined Epidural Analgesia with Total Intravenous Anesthesia on Risky Patients Underwent Major Abdominal Surgery

Ayazoğlu

Özensoy

Geyik

et al. 2015

Agri

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SummaryObjectives: The aim of this study is to investigate the effects of combined epidural analgesia with total intravenous anaesthesia and only total intravenous anaesthesia on the different clinical parameters. Methods: Sixty high risk patients undergoing a major abdominal surgical procedure were included in this prospective, double blind, randomized study. Induction of anaesthesia was performed with IV remifentanil 0.5µg/kg and propofol titrated to achieve bispectral index score between 40 and 50. after intubation; in Group E, 0.1% bupivacaine and 2 µg/mL fentanyl were administered by an infusion rate at 0.15 ml/kg/h via the epidural catheter and Group C received epidural normal saline as same infusion rate. Results:In group E, intraoperative MAP values were significantly lower than those in group C (p<0.05). Time of extubation, time of eye opening with audible warning and time of verbal response was significantly lower in group E than those in group C. Total anaesthetic drug consumption was significantly higher in group C than those in group E (p<0.05). Conclusion: Based on lower requirements for propofol and remifentanil as well as the favourable effects on clinical parameters; we conclude that bispectral index score guided combined epidural with total intravenous anaesthesia is superior to solely total intravenous anaesthesia in this type of surgery.

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Section: Discussionsupporting

confidence: 65%

Section: Introductionmentioning

confidence: 99%

Effects of Combined Epidural Analgesia with Total Intravenous Anesthesia on Risky Patients Underwent Major Abdominal Surgery

Ayazoğlu

Özensoy

Geyik

et al. 2015

Agri

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“…Paraskevi et al 6 reported nausea, prurutis which is not statistically significant between three groups similar to the present study. Decosmo et al, 7 observed minor side effects with similar incidence among Ropivacaine with sufentanil and levobupivacaine with sufentanil similar to the present study.…”

Section: Complicationssupporting

confidence: 91%

A Study on Evaluation of Epidural Levobupivacaine 0.125% and Ropivacaine 0.125% With and Without Fentanyl for Postoperative Pain Relief in Abdominal Surgeries

Shantiraj¹,

Kalyan²

2018

jebmh

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BACKGROUND Postoperative pain forms an acute category of non-malignant pain. Uncontrolled postoperative pain may produce range of detrimental acute and chronic effects. Postoperative epidural analgesia is an effective and well accepted modality of pain relief techniques after abdominal surgeries. The present study is to compare post-operative analgesia with epidural infusion of ropivacaine 0.125%, ropivacaine 0.125% with fentanyl, levobupivacaine 0.125%, levobupivacaine 0.125% with fentanyl for 24 hours in abdominal surgeries. MATERIALS AND METHODS The present study consists of 120 patients who got admitted in Viswabharathi Hospital, Kurnool and underwent abdominal surgeries during October 2014 to October 2015. RESULTS In this clinical study, 120 healthy patients of either sex belonging to ASA grade-I and grade-II were included. The patients were divided into four groups, group A, group B, group C and group D. Group A-Thirty patients received 0.125% Ropivacaine infusion for 24 hours at rate of 8 ml per hour epidurally. Group B-Thirty patients received 0.125% Ropivacaine with fentanyl 1 microgram per ml at the rate of 8 ml per hour infusion for 24 hours epidurally. Group C-Thirty patients received 0.125% Levobupivacaine infusion at the rate of 8 ml per hour for 24 hours epidurally. Group D-Thirty patients received 0.125% Levobupivacaine with fentanyl 1 microgram per ml at the rate of 8 ml per hour for 24 hours epidurally. The study was to compare quality of analgesia, haemodynamic changes, side effects, any associated motor block, amount of local anaesthetic consumed among 0.125% ropivacaine, 0.125% with fentanyl, 0.125% levobupivacaine, 0.125% levobupivacaine with fentanyl when administered as continuous epidural infusion for 24 hours. Analgesia was superior in levobupivacaine with fentanyl infusion and least in plain ropivacaine infusion. Differences in analgesia found in levobupivacaine, ropivacaine with fentanyl and plain levobupivacaine was not clinically significant. CONCLUSION We conclude from present study that levobupivacaine with fentanyl is an attractive option for postoperative epidural analgesia. Ropivacaine with fentanyl and levobupivacaine with fentanyl were of equianalgesic efficacy. Studies with levobupivacaine for postoperative analgesia are limited unlike ropivacaine. From the present study, it was found that plain 0.125% ropivacaine infusion is of lower analgesic efficacy probably due to the shorter duration of action and less potency of ropivacaine.

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“…A study was conducted by De Cosmo et.al comparing epidural analgesia after lung surgery. 15 In the study Ropivacaine 0.2% was compared with 0.125% Levo-Bupivacaine combined with sufentanil. They concluded that equivalent volumes of Ropivacaine 0.2% w/v and Levo-Bupivacaine 0.125% w/v provided similar static and dynamic analgesia with similar incidence of minor side effects after thoracotomy.…”

Section: Discussionmentioning

confidence: 99%

Post-operative Epidural Analgesia after TKR: A Double Blind Randomized Comparison of Ropivacaine 0.2% and Levobupivacaine 0.125%

Raj¹,

Tikle²,

Fernandes³

et al. 2019

IJCMR

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Introduction: With the increase in the life span of human beings and added to that the culture of processed food there are increase in life style disorders in humans. The commonest orthopedic problem which we see due sedentary life style, lack of healthy wholesome diet are bone related disorders mainly osteoarthritis. Ropivacaine, an alternative to bupivacaine is structurally closely related to bupivacaine and supplied as the pure S-enantiomer. We therefore decided to compare the efficacy of continuous infusion of levo bupivacaine against ropivacaine to identify the differences or superiority of one drug over other. Material and methods: After obtaining the Ethics Committee approval, we recruited 110 patients undergoing Total Knee Replacement (TKR) surgery under Combined Spinal Epidural (CSE) Anaesthesia. Sample size of study which was calculated as 110. All patients underwent a routine pre anaesthetic checkup including the spine examination. Pre-anaesthetic checkup was done a day prior to surgery. All routine investigations were advised. The details of our study were explained to the patients, in the language understood by them. Consent was obtained for post-operative use of Elastomeric infusion pump. They were explained about the use of VAS. Results: Both groups were comparable with respect to demographic profile. The patients in ropivacaine group showed significantly lower pulse rate as compared to levobupivacaine group. Patients in ropivacaine group recorded significantly lower systolic blood pressure throughout the infusion period as compared to those in the levobupivacaine group. The difference in diastolic blood pressure was not significant. The time taken for the sensory block to regress to L1 was longer in ropivacaine group as compared to levobupivacaine group. Conclusion: Patients in both the group had comparable VAS post operatively. Although Patients in the ropivacaine group had better VAS score as compared to levobupivacaine, the difference was not statistically significant. There were no side effects like motor weakness, hypotension, bradycardia or PNOV in any group. Our present study thus concludes that as far as analgesic properties are concerned Ropivacaine with its more suitable toxicity profile and less motor block is more favourable for continuous infusion for patients undergoing TKR when used in equipotent doses.

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Ropivacaine vs. levobupivacaine combined with sufentanil for epidural analgesia after lung surgery

Abstract: Equivalent volumes of ropivacaine (0.2% w/v) and levobupivacaine (0.125% w/v) provided similar static and dynamic analgesia with similar incidence of minor side-effects after thoracotomy.

Cited by 22 publications

References 22 publications

Effects of Combined Epidural Analgesia with Total Intravenous Anesthesia on Risky Patients Underwent Major Abdominal Surgery

Effects of Combined Epidural Analgesia with Total Intravenous Anesthesia on Risky Patients Underwent Major Abdominal Surgery

A Study on Evaluation of Epidural Levobupivacaine 0.125% and Ropivacaine 0.125% With and Without Fentanyl for Postoperative Pain Relief in Abdominal Surgeries

Post-operative Epidural Analgesia after TKR: A Double Blind Randomized Comparison of Ropivacaine 0.2% and Levobupivacaine 0.125%

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