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Can’t Blame Ropivacaine

Zeidan, Ahed, MD

doi: 10.1213/01.ANE.0000173763.58658.91
Letters to the Editor: Letters & Announcements

Department of Anesthesiology; Sahel General Hospital; Beirut, Lebanon;

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To the Editor:

James and Panni (1) described a case of an unusual prolonged unilateral spinal anesthesia (20 h) using isobaric ropivacaine. Previously, an exceptionally prolonged anesthesia (36 h) after spinal anesthesia has been reported, but the local anesthetic was an hyperbaric bupivacaine (2). Interestingly, in both cases, fentanyl was added to the local anesthetic. In James and Panni’s case, since a vasoconstrictor was not used and the addition of fentanyl to intensify and prolong ropivacaine block did achieve its intended purpose, as well as because of a lack of evidence to single out ropivacaine as the sole culprit for the protracted anesthesia, ropivacaine cannot be blamed alone. Also, the title would be better read as “Extremely Prolonged Unilateral Block with Spinal Ropivacaine plusFentanyl (20 hours) Used for Cervical Cerclage.”

Ahed Zeidan, MD

Department of Anesthesiology

Sahel General Hospital

Beirut, Lebanon

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1. James ML, Panni MK. Extremely prolonged unilateral block (20 hours) with spinal ropivacaine used for cervical cerclage placement. Anesth Analg 2005;100:897–8.
2. Arndt JA, Downey T. Exceptionally prolonged anesthesia after a small dose of intrathecal bupivacaine. Anesthesiology 2002;97:1042
© 2005 International Anesthesia Research Society