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Intrathecal anesthesia: ropivacaine versus bupivacaine
J M Malinovsky1, F Charles, O Kick
1Service d'Anesthésie-Réanimation Chirurgicale, Hôtel-Dieu, Nantes Cedex, France. jmmalino@chu-nantes.fr
Anesthesia and Analgesia
|November 30, 2000
Summary
Intrathecal ropivacaine (15 mg) provided similar motor and hemodynamic effects compared to bupivacaine (10 mg) for urological surgery. However, bupivacaine offered more potent sensory anesthesia, with less need for supplemental analgesics.
Area of Science:
- Anesthesiology
- Urology
Background:
- Intrathecal anesthesia is crucial for transurethral surgeries.
- Ropivacaine and bupivacaine are common local anesthetics used for spinal anesthesia.
- Determining equipotent doses and comparing clinical effects is essential for patient care.
Purpose of the Study:
- To compare the efficacy and safety of intrathecal ropivacaine versus bupivacaine in patients undergoing transurethral resection of bladder or prostate.
- To evaluate sensory and motor blockade characteristics, hemodynamic stability, and postoperative pain management.
Main Methods:
- A randomized, double-blind study involving 100 patients undergoing urological endoscopic surgery.
- Patients received either 10 mg isobaric bupivacaine or 15 mg isobaric ropivacaine intrathecally.
- Onset and offset of sensory and motor blockade, cephalad spread, and hemodynamic parameters were assessed.
Main Results:
- Bupivacaine demonstrated a significantly higher cephalad spread of sensory block compared to ropivacaine.
- Onset and offset times for sensory and motor blockade, as well as motor blockade duration, were similar between groups.
- No significant differences in hemodynamic effects or incidence of back pain were observed. Eight patients receiving ropivacaine required supplemental analgesia.
Conclusions:
- While 15 mg of intrathecal ropivacaine offers comparable motor and hemodynamic profiles to 10 mg of bupivacaine for urological procedures, it results in less potent sensory anesthesia.
- Bupivacaine may be preferred when a more extensive sensory block is desired for these surgeries.