Update on the clinical utility and practical use of ropivacaine in Chinese patients

Li, Man; Wan, Li; Mei, Wei; Tian, Yuan

doi:10.2147/dddt.s57258

Cited by 24 publications

(13 citation statements)

References 80 publications

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“…In this investigation, we performed the OSTAP block before general anesthesia induction and endotracheal intubation. Our results showed that several intraoperative parameters in group T, including sufentanil dosage, the number of patients who used a vasodilator and the time to extubation, were significantly less than those in group C. Compared with group C, cumulative sufentanil consumption till postoperative24h and NRS pain scores at 2 h and 4 h postopertively decreased significantly in group T. Our results were consistent with previous findings where TAP blocks have been described to last from 6 h to 24 h using ropivacaine [ 7 , 16 , 22 – 24 ]. The duration of the peripheral nerve block depends on several factors, such as the choice of local anesthetics, the site of injection and the presence of adjuncts.…”

Section: Discussionsupporting

confidence: 90%

“…The duration of the peripheral nerve block depends on several factors, such as the choice of local anesthetics, the site of injection and the presence of adjuncts. Ropivacaine is the most frequently used local anesthetic for peripheral nerve block in the People’s Republic of China [ 22 ]. Lee et al [ 16 ] demonstrated that maximal dermatome spread was observed at 30 min and usually regressed by 24 h. Although few studies have shown the analgesic effect lasting longer than 24 h [ 25 ], Stoving et al [ 24 ] demonstrated that the blockade duration of ultrasound-guided unilateral TAP block with 20 mL 75 mg/mL ropivacaine was approximately 10 h with a large variation in healthy volunteers.…”

Section: Discussionmentioning

confidence: 99%

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The analgesic efficacy of subcostal transversus abdominis plane block with Mercedes incision

Guo

Pei³

et al. 2018

BMC Anesthesiol

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BackgroundConventional perioperative analgesic modalities (e.g. opioids, epidural analgesia) have their own drawbacks, which limit their clinical application. This study investigated the opioid-sparing effectsof the oblique subcostal transversus abdominis plane (OSTAP) blockade with ropivacaine for the patients undergoing open liver resection with a Mercedes incision.Methods126 patients who were scheduled for open liver resection were enrolled in this study. Patients were randomly assigned to receive bilateral ultrasound-guided OSTAPblocks with either 0.375% ropivacaine (groupT) or 0.9% isotonic saline (group C). Both groups also received intravenous patient-controlled analgesia and intravenous 40 mg parecoxib every 12 h for a total of 3 days. Preoperative and intraoperative parameters, plus intraoperative and postoperative cumulative sufentanil consumption, were recorded.Results70 patients were enrolled in the study finally. There were no significant differences between the two groups with respect to preoperative parameters, and surgical and anesthetic characteristics. The intraoperative sufentanil use, cumulative sufentanil consumption at 5 min after extubation, 2 h, 4 h,12 h and 24 h after operation in group T was significantly less than that in group C (P = 0.001, 0.001, 0.000, 0.000, 0.001 and 0.044, respectively). Compared with group C, postoperative NRS pain scores at rest were significantly lower at 2 h and 4 h postoperatively in group T (P = 0.04and 0.02, respectively); NRS scores at the time of coughing were also significantly lower in group T than in group C at all time points except 5 min after extubation (all P < 0.001). Furthermore, compared with group C, the number of intraoperative vasodilator use, the extubation time and the incidence of nausea was reduced in group T.ConclusionUltrasound-guided OSTAP block with ropivacaine can significantly decrease the perioperative cumulative dosage of analgesics and improve analgesic effect without obvious side effects for the patients who underwent an open liver resection with Mercedes incision when compared tothe ultrasound-guided OSTAP block with saline.Trial registrationThe study protocol was registered at http://www.chictr.org.cn (ChiCTR-TRC- 14004827) on February 19, 2014.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

The analgesic efficacy of subcostal transversus abdominis plane block with Mercedes incision

Guo

Pei³

et al. 2018

BMC Anesthesiol

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“…Meta‐analyses confirm that a local anesthetic injection reduces postoperative pain for pediatric tonsillectomies on PODs 0 and 1, consistent with a prior meta‐analysis with 7 studies utilizing topical or locally injected anesthetics 3 . Bupivacaine (with or without epinephrine), levobupivacaine (with or without epinephrine), lidocaine with epinephrine, and ropivacaine all have a duration of action of 3 to 6 hours, making them easier to compare than other anesthetics 16–18 . Interestingly, subgroup analysis on pain scores reported in the 4‐ to 8‐hour time frame identified a significant difference favoring local anesthetic in 2 groups: cold technique only and cold technique with electrocautery.…”

Section: Discussionsupporting

confidence: 76%

Effect of Local Anesthetic Injections on Subjective Pain Scales in Pediatric Tonsillectomies: A Meta‐analysis

Ortega

Brigger

Nation

2022

Otolaryngol.--head neck surg.

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Objective To assess the effect of local anesthetic injection on subjective pain scores for pediatric tonsillectomies on postoperative days (PODs) 0 and 1. Data Sources A comprehensive literature search was conducted with the PubMed, Embase, Web of Science, and Scopus databases. Review Methods A 2-researcher team following the PRISMA guidelines performed a systematic review and meta-analysis. Studies with original data and a saline injection control arm were selected. Corresponding authors were contacted for missing data. The collated data were analyzed with RevMan version 5.4 (Review Manager; Cochrane Collaboration). Random effects modeling and standard mean difference were utilized to control for heterogeneity. Surgical technique subgroup analysis was performed. Results A total of 319 publications were identified, and 8 articles with 13 experimental arms (627 participants) were selected for meta-analysis. Local anesthetic injection was compared with placebo with saline injection. The standard mean difference for POD 0 pain was −0.81 (95% CI, −1.16 to −0.46; P < .00001) in favor of local anesthetic. The standard mean difference for POD 1 was −1.13 (95% CI, −1.48 to −0.78; P < .00001) in favor of local anesthetic. Subgroup analysis by surgical technique showed a less robust effect for cautery excision (−1.01 [95% CI, −1.37 to −0.66]) vs cold excisional technique (−1.19 [95% CI, −1.64 to −0.74]), with or without cautery-based hemostasis. Conclusions A local anesthetic injection during a pediatric tonsillectomy reduces postoperative pain on POD 0 and 1. Further analysis on total narcotic use and postoperative complications would benefit surgeon decision making.

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“…observed in rats with this ophthalmic formulation of oxybuprocaine, which agrees with these aforementioned studies [5,9,11]. The clinical use of ropivacaine hydrochloride has increased in human anesthesia and analgesia practice in recent years [25]. While, several studies have addressed the clinical utility of ropivacaine hydrochloride in human and veterinary ophthalmology [26][27][28][29][30].…”

Section: Plos Onesupporting

confidence: 81%

“…The clinical use of ropivacaine hydrochloride has increased in human anesthesia and analgesia practice in recent years [ 25 ]. While, several studies have addressed the clinical utility of ropivacaine hydrochloride in human and veterinary ophthalmology [ 26 – 30 ].…”

Section: Discussionmentioning

confidence: 99%

Effects of topical application of 0.4% oxybuprocaine hydrochloride ophthalmic solution and 1% ropivacaine hydrochloride on corneal sensitivity in rats

Lelescu¹,

Urda-Cîmpean

Dumitraş

et al. 2020

PLoS ONE

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The aim of the present study was to determine and compare the degree and duration of corneal anesthesia following topical application of 0.4% oxybuprocaine hydrochloride ophthalmic solution and 1% ropivacaine hydrochloride treatment in healthy rats. A randomized, blinded, crossover study was conducted on 20 healthy adult Wistar rats, following complete physical and ophthalmological examination. Baseline corneal touch threshold (CTT) was determined in the central corneal area of both eyes with a Cochet–Bonnet aesthesiometer, in mm filament length. Oxybuprocaine was randomly applied to one eye and 0.9% sterile sodium chloride solution was instilled into the contralateral eye. Subsequent CTT measurements were performed in both eyes 5 minutes after topical application and at 5-minute intervals thereafter for 75-minutes in the anesthetized eye. Following a 2-week washout period, this protocol was repeated with ropivacaine. Quantitative data were summarized as mean ± standard deviation, median and inter-quartile range (Q1–Q3). Repeated measures data were analyzed over time and between treatments using Friedman test and Wilcoxon signed-rank test with Bonferroni adjustment (p < 0.05). Baseline CTT values were 60 mm in all eyes. With oxybuprocaine, CTT values decreased significantly for 65 minutes (0–55 mm; p = 0.002) when compared with baseline; the maximal anesthetic effect (no blink response at 5 mm filament length) was maintained for up to 15 minutes (p < 0.0001). With ropivacaine, CTT values were significantly lower than baseline for 30 minutes (0–55 mm; p = 0.002), with a maximal anesthetic effect recorded at 5 minutes in 18 eyes (p < 0.0001). Oxybuprocaine induced a significantly lower CTT than ropivacaine (p = 0.002) from 10 to 65 minutes following topical application. Both anesthetic agents induced significant corneal anesthesia; however, oxybuprocaine provided a greater and longer anesthetic effect, making it more suitable for potentially painful ophthalmologic procedures.

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Update on the clinical utility and practical use of ropivacaine in Chinese patients

Cited by 24 publications

References 80 publications

The analgesic efficacy of subcostal transversus abdominis plane block with Mercedes incision

The analgesic efficacy of subcostal transversus abdominis plane block with Mercedes incision

Effect of Local Anesthetic Injections on Subjective Pain Scales in Pediatric Tonsillectomies: A Meta‐analysis

Effects of topical application of 0.4% oxybuprocaine hydrochloride ophthalmic solution and 1% ropivacaine hydrochloride on corneal sensitivity in rats

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