Spinal anaesthesia: comparison of plain ropivacaine 5 mg ml-1 with bupivacaine 5 mg ml-1 for major orthopaedic surgery

McNamee, David; McClelland, A. M.; Scott, Steven M.; Milligan, K. R.; Westman, Lars; Gustafsson, U.

doi:10.1093/bja/89.5.702

Cited by 89 publications

(95 citation statements)

References 16 publications

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“…However, in other studies no significant defference was foud in haemodynamics in both ropivacaine and bupivacaine groups when given intrathecally. [18][19][20][23][24][25] In present study no rescue analgesia was required in any of the patients in any group and quality of anesthesia obtained was adequate with both the groups. No signs of central nervous system toxicity (like restlessness, anxiety, incoherent speech, lightheadedness, dizziness, blurred vision, tremors, drowsiness, convulsions) or cardiovascular system toxicity (hypotension, bradycardia, hypertension, tachycardia, vasovagal reaction, arrhythmias like extra-systoles, atrial fibrillation, ST segment changes and myocardial infarction); severe allergic reactions (rash, itching, difficulty in breathing, tightness in the chest, swelling of the mouth, face, lips or tongue); nausea; vomiting noted in both groups.…”

Section: Discussionmentioning

confidence: 73%

“…The findings correlate with the different studies. [17][18][19][21][22][23][24][25][26] The average highest level of sensory blockade which was achieved by giving either 3.5 ml of 0.75% isobaric ropivacaine or 3.5 ml of 0.5% hyperbaric bupivacaine was compared. The average highest level of sensory blockade in both the groups was T6 which was comparable (P=0.879).…”

Section: Discussionmentioning

confidence: 99%

“…Similar results were observed by various authors in their studies. 17,[19][20][21]23,26 No significant change in heart rate in ropivacaine group was found but there was significant fall in heart rate after 60 minutes of the induction in bupivacaine group by paired 't' test. The maximum fall in heart rate was 7% at 120 minutes in bupivacaine group while it was 3% at 60 minutes in ropivacaine group.…”

Section: Discussionmentioning

confidence: 99%

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A double blind prospective study of effect of intrathecal ropivacaine 0.75% and bupivacaine 0.5% for lower limb orthopedic surgery in young patients

Sule¹,

Basantwani²

2016

Int J Basic Clin Pharmacol

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Section: Discussionmentioning

confidence: 73%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A double blind prospective study of effect of intrathecal ropivacaine 0.75% and bupivacaine 0.5% for lower limb orthopedic surgery in young patients

Sule¹,

Basantwani²

2016

Int J Basic Clin Pharmacol

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“…1 A recent clinical trial comparing levobupivacaine 0.5% with ropivacaine 0.5% for the management of postoperative ankle surgery pain found that levobupivacaine provide more long lasting postoperative analgesia compared with the same dose of ropivacaine, in contrast McNamee et al reported that intrathecal administration of 17.5 mg plain ropivacaine 0.5% or plain bupivacaine 0.5% resulted in similarly effective anesthesia for total hip arthroplasty. 2,3 We have planned the study to evaluate effect of plain ropivacaine 0.5% versus plain levobupivacaine 0.5% in gynecological surgeries.…”

Section: Introductionmentioning

confidence: 99%

Comparative study of ropivacaine (0.5%) plain versus levobupivacaine (0.5%) plain in gynecological surgeries

Jain

Bendwal

Deodhar

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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Background: Regional anesthesia increasingly used for gynecological surgeries, has advantage of decreased stress response to surgery, decreased cardiorespiratory depression, with improved postoperative analgesia.Methods: This randomized, prospective, double blind study was conducted at Amaltas Institute of Medical Sciences, Banger Dewas in Department of Anesthesia between June 2016-December 2016. Sixty patients who were posted for gynecological surgeries were enrolled and randomly divided into two groups: Group R received 3.5 ml (17.5 mg) 0.5% ropivacaine plain and Group L received 3.5 ml (17.5 mg) 0.5% levobupivacaine plain. The onset and duration of sensory and motor block and any undesirable side effects were noted.Results: Demographic parameters were comparable between the two groups (P >0.05). Onset of sensory and motor block was significantly faster in Group L, duration of motor and sensory block was significantly less in Group R. Patients in group R were hemodynamically stable (P = 0.032) compared to group L.Conclusions: Both ropivacaine and levobupivacaine have the desirable blocking property and can be used in gynecological surgeries. Ropivacaine showed shorter duration of sensory and motor block allowed early mobilization and early recovery of patients.

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“…10 These findings are also consistent with various other studies conducted by Van Kleef et al, Gautier et al, Mc Namee et al, which state that ropivacaine has got lesser motor blockade due to its low lipid solubility resulting in lesser penetration of thick motor fibres. [9][10][11] The time taken for two segment regression of sensory blockade, total duration of sensory blockade and motor blockade were significantly prolonged in group B as compared to group A. This suggests that the duration of analgesia increases with increase in concentration of the drug.…”

mentioning

confidence: 99%

A prospective, comparative, observational study of quality of spinal anaesthesia with 0.5% and 0.75% plain isobaric ropivacaine in lower abdomen and lower limb surgeries

Gupta

Amilkanthwar

2016

Int J Res Med Sci

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INTRODUCTIONSpinal anaesthesia or subarachnoid block remains one of the basic techniques in the arsenal of modern anaesthesiology. The spinal anaesthesia has the potential for being uniquely safe anaesthetic technique due to the combination of profound analgesia, muscle relaxation and less systemic and metabolic disturbances. Preservation of airway, decrease blood loss and ability to provide residual postoperative analgesia are further advantages.1 Spinal or intrathecal anaesthesia has a long history of success and is more popular, mostly due to an increasing number of ambulatory procedures and interventions, for which the ideal spinal anaesthetic would provide rapid and adequate surgical anaesthesia together with early ambulation to allow early discharge.Bupivacaine is extensively used and produces an adequate sensory and motor blockade.2 Although intrathecal bupivacaine has low incidence of ABSTRACT Background: Spinal anaesthesia or subarachnoid block remains one of the basic techniques in the arsenal of modern anaesthesiology. Aim of the study was to evaluate and compare quality of spinal anaesthesia with isobaric 0.5% and 0.75% intrathecal ropivacaine in patients undergoing lower abdominal and lower limb surgeries. Methods: 100 patients between 18 and 60 years, of either gender belonging to ASA class I or II, posted for elective lower abdominal and lower limb surgeries, planned under spinal anaesthesia using ropivacaine. Patients were grouped as group A: 3 ml (15 mg) of 0.5% plain ropivacaine and Group B: 3ml (22.5mg) of 0.75% plain ropivacaine. Parameters observed were onset and duration of sensory and motor block, maximum sensory level achieved degree of motor blockade, two segment regression, and haemodynamic changes. Results: No significant differences were noted in Mean time for onset and time to achieve maximum level of sensory and motor blockade in both groups. Maximal dermatomal level was T10 in group A and T8 in group B which was statistically significant. Also, 96% patients had grade III motor blockade in group B as compared to 80% in group A which was statistically significant. Significant differences were noted in Time for two segment regression (92.56±11.846 minutes in group A and 137.3±13.06 min in group B), the duration of sensory blockade (184.5±18.385 min in group A and 238.8±19.260 min in group B) and duration of motor blockade (120.3±15.59 min in group A and 178.8±16.053 min in group B). Conclusions: Intrathecal isobaric ropivacaine 0.5% and 0.75% are safe and effective with minimal intraoperative and postoperative side effects. Recommended for short duration orthopaedic and lower abdominal surgeries where prolonged motor blockade is undesirable.

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Spinal anaesthesia: comparison of plain ropivacaine 5 mg ml-1 with bupivacaine 5 mg ml-1 for major orthopaedic surgery

Cited by 89 publications

References 16 publications

A double blind prospective study of effect of intrathecal ropivacaine 0.75% and bupivacaine 0.5% for lower limb orthopedic surgery in young patients

A double blind prospective study of effect of intrathecal ropivacaine 0.75% and bupivacaine 0.5% for lower limb orthopedic surgery in young patients

Comparative study of ropivacaine (0.5%) plain versus levobupivacaine (0.5%) plain in gynecological surgeries

A prospective, comparative, observational study of quality of spinal anaesthesia with 0.5% and 0.75% plain isobaric ropivacaine in lower abdomen and lower limb surgeries

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