Thoracic epidural anesthesia with ropivacaine for plastic surgery

Area of Science:

• Anesthesiology
• Surgical Procedures
• Pharmacology

Background:

• Thoracic epidural blockade is a recognized method for inducing hypotensive anesthesia, aiming to minimize surgical bleeding.
• This study focuses on the combined use of 0.5% ropivacaine and propofol continuous infusion sedation for plastic surgery.

Purpose of the Study:

• To evaluate the efficacy and safety of thoracic epidural blockade with 0.5% ropivacaine and propofol sedation.
• To assess the impact on bleeding reduction during combined plastic surgeries.

Main Methods:

• A non-comparative study involving 60 female patients (ASA I or II) undergoing combined plastic surgeries.
• Administration of 40 ml 0.5% ropivacaine with 15 mcg sufentanil for epidural blockade, supplemented as needed.
• Propofol continuous infusion (40-50 mcg kg(-1) min(-1)) for sedation, with monitoring of hemodynamic, respiratory, and blockade parameters.

Main Results:

• Achieved upper sensory block levels primarily at T2 (86.6%), with mean onset time of 9.1 min.
• Significant decrease in systolic blood pressure (SBP), diastolic blood pressure (DBP), mean blood pressure (MBP), and heart rate (HR), indicating successful hypotensive anesthesia.
• No patient required blood transfusion; vasopressors and atropine were administered in 21.7% and 6.7% of patients, respectively.

Conclusions:

• Thoracic epidural blockade with 0.5% ropivacaine and propofol sedation is a satisfactory hypotensive anesthesia technique for extensive plastic surgeries.
• Close monitoring of hemodynamic and respiratory parameters is essential for the safe application of this anesthesia technique.