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An Open Study Comparison of 0.5%, 0.75% and 1.0% Ropivacaine, with Epinephrine, in Epidural Anesthesia in Patients Undergoing Urologic Surgery
  1. Hans E.M. Kerkkamp, M.D.*,
  2. Kjell H. Axelsson, M.D., PH.D.**,
  3. Hakan H. Edstrom, PH.D.,
  4. Mathieu J.M. Gielen, M.D., PH.D.*,
  5. William Dirkes, M.D.,
  6. Magnus Wattwil, M.D.** and
  7. Henrik Kehlet, M.D., PH.D.
  1. *Institute for Anesthesiology, University of Nijmegen, Nijmegen, the Netherlands
  2. **Orebro Medical Center Hospital, Orebro, Sweden
  3. Department of Gastroenterology and Anesthesiology, Hvidovre University Hospital, Hvidovre, Denmark
  4. Astra Pain Control, Södertälje, Sweden

Abstract

Ropivacaine 0.5%, 0.75% and 1.0% with epinephrine 5 μg/ml was investigated in an open, multi-center study for lumbar epidural anesthesia in 46 patients undergoing urologic surgery. The onset time for analgesia to T12 was 5-7 minutes after the end of the ropivacaine injection. Maximum segmental levels of analgesia (T4-6) were not different between the groups. Complete motor blockade was obtained in 3/15, 7/15 and 10/15 patients in the 0.5%, 0.75% and 1.0% groups, respectively. Duration of analgesia at the T10 level was 2.5 hours in the 0.5% group, and increased to 4 hours in the 1.0% group. Analgesia was satisfactory for surgery in all patients except for 2/15 in each of the 0.5% and 0.75% groups and 1/15 in the 1.0% group. Hypotension was experienced by three, six and three patients in the 0.5%, 0.75% and 1.0% groups, respectively. Bradycardia was seen in two patients in the 0.5% group and one patient in the 1.0% group. Backache was experienced by seven patients (four in the 0.5%, two in the 0.75% and one in the 1.0% group). No late-occurring adverse experiences were observed. In conclusion, 0.5%, 0.75% and 1.0% ropivacaine with epinephrine provide adequate analgesia and motor blockade for urologic surgery.

  • Lumbar epidural anesthesia
  • ropivacaine
  • epinephrine
  • urologic surgery

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