The effect of warmed ropivacaine to body temperature on epidural sensory block characteristics

Liu, Fu-Chao; Liou, Jiin-Tarng; Li, Allen H.; Day, Yuan-Ji; Yu, Huang-Ping

doi:10.1016/j.jclinane.2009.03.014

Cited by 7 publications

(3 citation statements)

References 18 publications

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“…Apart from peripheral nerve block, several studies have investigated the effect of warming local anesthetics on neuraxial block. Liu et al [ 18 ] demonstrated that the administration of warming ropivacaine significantly accelerated the onset time of T12 and L3 sensory blockade for epidural anesthesia. Arai et al [ 19 ] discovered that warming caused a reduction in the viscosity of bupivacaine solutions, resulting in an elevation of the cephalad level of spinal anesthesia.…”

Section: Discussionmentioning

confidence: 99%

The effect of warming ropivacaine on ultrasound-guided subgluteal sciatic nerve block: a randomized controlled trial

He,

Ma,

Zhou

et al. 2023

BMC Anesthesiol

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Background There is a long latent period for the sciatic nerve block before a satisfactory block is attained. Changes in the temperature of local anesthetics may influence the characters of the peripheral nerve block. This study was designed to evaluate the effect of warming ropivacaine on the ultrasound-guided subgluteal sciatic nerve block. Methods Fifty-four patients for distal lower limbs surgery were randomly allocated into warming group (group W, n = 27) or room tempeture group (group R, n = 27) with the ultrasound-guided subgluteal sciatic nerve block. The group W received 30 ml of ropivacaine 0.5% at 30℃ and the group R received 30 ml of ropivacaine 0.5% at 23℃. The sensory and motor blockade were assessed every 2 min for 30 min after injection. The primary outcome was the onset time of limb sensory blockade. Results The onset time of sensory blockade was shorter in group W than in group R (16 (16,18) min vs 22 (20,23) min, p < 0.001), and the onset time of motor blockade was also shorter in group W than in group R (22 (20,24) min vs 26 (24,28) min, p < 0.001). The onset time of sensory blockade for each nerve was shorter in group W than in group R (p < 0.001). No obvious differences for the duration of sensory and motor blockade and the patient satisfaction were discovered between both groups. No complications associated with nerve block were observed 2 days after surgery. Conclusions Warming ropivacaine 0.5% to 30℃ accelerates the onset time of sensory and motor blockade in the ultrasound-guided subgluteal sciatic nerve block and it has no influence on the duration of sensory and motor blockade. Trial registration The trial was registered on October 3, 2022 in the Chinese Clinical Trial Registry (https://www.chictr.org.cn/bin/project/edit?pid=181104), registration number ChiCTR2200064350 (03/10/2022).

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Section: Discussionmentioning

confidence: 99%

The effect of warming ropivacaine on ultrasound-guided subgluteal sciatic nerve block: a randomized controlled trial

He,

Ma,

Zhou

et al. 2023

BMC Anesthesiol

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“…Using bupivacaine and prilocaine in the brachial plexus block, Heath et al [10] reported that the onset time of the nerve block was shortened by 30% and 50%, respectively, by warming of the local anesthetics, depending on the nerves. Similarly, using ropivacaine in an epidural block, Liu et al [15] also reported that the onset time of the epidural block was shortened by warming of the local anesthetic, and there were no side effects related to warming. These results can be explained as warming of the anesthetic decreased pKa value and increased permeability through the non-neural tissue to the nerve, which can also support our results [16,17].…”

Section: Discussionmentioning

confidence: 99%

Effect of warmed ropivacaine solution on onset and duration of axillary block

Lee

Kim

Choi

et al. 2012

Korean J Anesthesiol

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BackgroundBicarbonate, as an adjunct increasing the non-ionized form of local anesthetics, can reduce latency and prolong duration of regional nerve block. Warming of local anesthetics decreases pKa and also increases the non-ionized form of local anesthetics. We warmed ropivacaine to body temperature (37℃) and evaluated the sensory block onset time, motor block onset time and analgesic duration of axillary block.MethodsPatients were consecutively allocated to two groups of 22 patients each. Ropivacaine 150 mg (30 ml) at 20℃ (room temperature) and 150 mg (30 ml) at 37℃ (body temperature) was injected in group 1 and group 2, respectively. Sensory block and motor block was assessed every 5 minutes, for 30 minutes after injection. The duration of analgesia was recorded after operation.ResultsIn group 2, the onset times of both sensory and motor block of the radial, ulnar, median and musculocutaneous nerves were significantly reduced, compared to group 1. Also, the number of blocked nerves was increased in group 2, within 30 minutes after injection. Analgesia lasted for 2 hours longer in group 2, compared to group 1, but the difference was not statistically significant (P > 0.05).ConclusionsWarming of ropivacaine to 37℃ can reduce the onset time of both sensory and motor block, during axillary block.

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“…10 Some researchers have demonstrated that the use of warm lidocaine hastens the onset of action in epidural analgesia and this finding could be due to an increased rate of passive diffusion across non-neural structures or a reduction in pKa, which causes an increase in the non-ionized fraction of local anaesthetic that can cross the neural membranes. 7, 13 According to Trabelsi et al, heating increases the diffusion capacity of local anaesthetic, thereby resulting in early onset of the action. 14 The duration of sensory blockade and the median highest sensory level has shown comparable results without any significance.…”

Section: Figure 4 -Number Of Patients With Hypotension Episodes In Ea...mentioning

confidence: 99%

Comparison of Subarachnoid Block Characteristics with Levobupivacaine at 24<sup>0</sup>C and 37<sup>0</sup>C for Infra-Umbilical Surgeries - a Randomized Controlled Trial

Nag¹,

Charles

Balachandar

et al. 2022

Sri Lankan J Anaesthesiol

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Background & Aim: The temperature of a local anaesthetic solution influences its pKa and molecular kinetic activity, thereby affecting baricity. We evaluated the effects of 0.5% Levobupivacaine preheated at 37ºC on sensory and motor block characteristics and haemodynamic in patients undergoing infra-umbilical surgeries. Methods: This was a prospective, randomised, double blinded study, in which 70 patients were allocated into two groups [Group A (n=35) and Group B (n=35)]. In Group A, patients were administered 3 mL of levobupivacaine 0.5% solution at room temperature (24 -28ºC) and patients in Group B were administered with 3 mL of levobupivacaine 0.5% solution at 37°C (Thermostatically controlled digitalized hot bath machine) into the subarachnoid space. Our primary objective was to determine the time of onset of sensory blockade at T10. Time of onset and duration of motor blockade, duration of analgesia, time to two segment regression and other adverse events after spinal anaesthesia were secondary objectives. Results:The time to reach a sensory block of T10 was significantly shorter in group B (Mean ±SD 2.7±2.9 min, P 0.005) compared to that in group A (Mean ±SD 4.8±4.5 min). The mean duration of sensory block was longer in group B (Mean ±SD 155.5±25.9 min, P 0.048). Time to onset of motor block, duration of motor block and time to regression of two dermatomal level were not found statistically significant among the two groups. Conclusion: Spinal anaesthesia with 0.5% levobupivacaine heated to 37ºC shortens sensory block onset time and provides longer block duration.

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The effect of warmed ropivacaine to body temperature on epidural sensory block characteristics

Cited by 7 publications

References 18 publications

The effect of warming ropivacaine on ultrasound-guided subgluteal sciatic nerve block: a randomized controlled trial

The effect of warming ropivacaine on ultrasound-guided subgluteal sciatic nerve block: a randomized controlled trial

Effect of warmed ropivacaine solution on onset and duration of axillary block

Comparison of Subarachnoid Block Characteristics with Levobupivacaine at 24<sup>0</sup>C and 37<sup>0</sup>C for Infra-Umbilical Surgeries - a Randomized Controlled Trial

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