当前位置： SCI文献检索 > ACTA ANAESTHESIOLOGICA SCANDINAVICA期刊下所有文献 > Epidural ropivacaine -- where are the benefits? A prospective, randomized, double-blind trial in patients with retropubic prostatectomy.

Epidural ropivacaine -- where are the benefits? A prospective, randomized, double-blind trial in patients with retropubic prostatectomy.

Abstract：

BACKGROUND:In comparison with bupivacaine, ropivacaine exhibits comparable anaesthetic effects but with less motor impairment and systemic toxicity. However, the analgesic potency may differ. For example, ropivacaine during obstetric epidural analgesia provides an approximately 40% lower analgesic potency than bupivacaine. Equal visual analogue pain scores require significantly higher dosages of ropivacaine, and general statements about a favourable benefit-risk profile relative to that of bupivacaine may therefore have limited clinical impact. We addressed this topic in a male pain model by evaluating the analgesic efficacy of epidural ropivacaine 0.2% vs. bupivacaine 0.125% after retropubic prostatectomy. METHODS:Forty patients scheduled for retropubic prostatectomy were randomly assigned to two groups (20 patients per group). In a double-blind prospective design, patient-controlled lumbar epidural analgesia was provided by ropivacaine 0.2% in the ropivacaine group and by bupivacaine 0.125% in the bupivacaine group. The primary endpoint was the total amount of local anaesthetic consumption. The secondary endpoints were the numeric rating scale scores for rest and dynamic pain and the degree of motor impairment. RESULTS:Ropivacaine consumption was 60% higher (mean +/- standard deviation, 1372.5 +/- 108.3 mg) than that of bupivacaine (852 +/- 75.2 mg) (P < 0.001). There were no significant differences in the numeric rating scale scores and motor impairment. CONCLUSIONS:In male patients, lumbar epidural administration of ropivacaine 0.2% after retropubic prostatectomy does not appear to provide benefits over bupivacaine 0.125%. Moreover, in view of the significantly higher drug requirements, general statements focusing on the favourable therapeutic index of ropivacaine may require critical analysis, at least during epidural administration.

journal_name

Acta Anaesthesiol Scand

journal_title

Acta anaesthesiologica Scandinavica

authors

Heid F,Schmidt-Glintzer A,Piepho T,Jage J

doi

10.1111/j.1399-6576.2006.01259.x

subject

Has Abstract

pub_date

2007-03-01 00:00:00

pages

294-8

issue

eissn

0001-5172

issn

1399-6576

pii

AAS1259

journal_volume

pub_type

杂志文章,随机对照试验

在线工具

Epidural ropivacaine -- where are the benefits? A prospective, randomized, double-blind trial in patients with retropubic prostatectomy.