Spinal Hyperbaric Ropivacaine-Fentanyl for Day-Surgery

Low-dose ropivacaine-sufentanil spinal anaesthesia for caesarean delivery: a randomised trial

“…8,9 Several recent studies have described the use of hyperbaric ropivacaine with fentanyl for spinal anaesthesia in both non-obstetric and obstetric patients. [10][11][12] Two studies have described the use of intrathecal low-dose plain or isobaric ropivacaine with sufentanil for obstetric patients, 13,14 but anaesthesia was effective in only 87% and 77% of cases respectively. Hyperbaric ropivacaine may be preferable as its cephalad spread and reliability of anaesthesia are improved.…”

Combination of hyperbaric lidocaine and ropivacaine in spinal anaesthesia for day surgery

“…hyperbaric ropivacaine 10 mg; pH 3.91. In a previous study [5], 1.5 mL of ropivacaine 10 mg mL Ϫ1 ϩ 0.5 mL of glucose 300 mg mL Ϫ1 has been found to have a density (1.02584 g cm Ϫ3 at 37°C) typical of hyperbaric local anaesthetic solutions [6].…”

“…The patient was kept in the lateral decubitus position for 5 min before turning to the supine horizontal position for surgery. At 5,10,15,20,25,30,45, 60, 75, 90, 120, 150, 180, 210, 240 and 270 min from the intrathecal injection, development of sensory and motor blocks were tested on both sides of the body by an anaesthesiologist blinded regarding the allocation into study groups. Extension of the sensory block was tested using a short bevel 27-G pinprick needle.…”

“…Estimation of sample size was performed using the results from the trial of Ben-David and colleagues [7] who described sensory recovery of the S2 dermatome in 110 Ϯ 25 min with hyperbaric lidocaine 50 mg and our previous work with ropivacaine 15 mg in glucose 7.5% [5] showing bilateral regression to S2 in 198 min. When these times are linearly extrapolated to this present study, time to S2 sensory recovery would be 110 min with lidocaine 20 mg ϩ ropivacaine 5 mg and 132 min with ropivacaine 10 mg, the difference in means would be 22 min.…”

“…However, since the recovery of the sensory block outlasts that of the motor block after ropivacaine spinal anaesthesia [3,4] the attainment of discharge criteria after surgery may still be delayed. By lowering the dose of hyperbaric ropivacaine from 15 mg to 10 mg, replacing the difference with 20 µg of fentanyl, the motor block was reduced to an hour and the patients were able to walk about 2.5 h from the intrathecal injection [5]. However, mild pruritus occurred in 60% of the patients who received intrathecal fentanyl.…”