Local and Regional Anaesthesia
Background and Goal of Study: Ropivacaine is a long acting amide local anesthetic agent, administered epidurally to patients undergoing various surgical procedures(1). The aim of this study was to assess the efficacy and clinical outcome of epidural ropivacaine combined with sufentanil in a randomized, double-blind, controlled trial.
Materials and Methods: After approval of the local ethics committee and informed consent, forty male patients (ASA I-II, aged between 30-65) under-going inguinal hernia repairment under epidural anesthesia were assigned into two groups receiving 0.75%, 15mL ropivacaine (Group I) or 0.75%, 15mL ropivacaine combined with 10 mcg sufentanil (Group II). The spread and duration of sensory anesthesia was assessed by pinprick, and that motor block was assessed using a Modified Bromage Scale. A blinded observer evaluated onset time and regression of motor and sensory block, quality of analgesia, hemodynamic parameters, time to first analgesic requirements and all side effects. Pain was measured on a visual analog scale (VAS: 0: no pain; 10cm: unbearable pain). SPSS for Windows 10.0 were used in statistical analysis and p values <0.05 was considered statistically significant.
Results: There were no differences in respect of patient characteristics, initial onset and degree of motor block, quality of analgesia, peak sensory block level and all side effects. VAS scores and haemodynamic parameters were similar. The onset time of sensory block was 4.93 ± 0.69 min and 3.72 ± 1.37 min in Group I and II respectively (p < 0.001). The time to first analgesic requirement was longer, although the two-segment regression time was shorter in Group II (p < 0.001).
Conclusion(s): Epidural anesthesia with ropivacaine plus sufentanil provided efficient pain relief, haemodynamic stability and minor side effects. A clinical concern regarding patient satisfaction, the rapid regression of sensory and motor block and longer duration of analgesia might be advantageous.
1 Svedberg K, McKenzie J. J Clin Pharm Ther 2002 Feb;27(1):39-45.