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Lateral Approach to the Sciatic Nerve in the Popliteal Fossa: A Comparison Between 1.5% Mepivacaine and 0.75% Ropivacaine
  1. Manuel Taboada, M.D.,
  2. Joaquín Cortés, M.D., Ph.D.,
  3. Jaime Rodríguez, M.D., Ph.D.,
  4. Beatriz Ulloa, M.D.,
  5. Julián Álvarez, M.D., Ph.D. and
  6. Peter G Atanassoff, M.D.
  1. From the Department of Anesthesiology (M.T., J.C., J.R. B.U., J.A.), Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain
  2. Department of Anesthesiology, Yale University School of Medicine, New Haven, Connecticut, Spain
  1. Reprint requests: Manuel Taboada, M.D., Department of Anesthesiology, Hospital Clínico Universitario de Santiago, Travesía da Choupana s/n, 15706, Santiago de Compostela, Spain. E-mail: manutabo{at}


Background and Objectives Ropivacaine and mepivacaine are commonly used local anesthetics for peripheral nerve blockade. The purpose of the present study was to compare onset time, quality of anesthesia, and duration of analgesia with ropivacaine 0.75% and mepivacaine 1.5% for lateral popliteal nerve block.

Methods Fifty American Society of Anesthesiologists (ASA) physical status I or II patients scheduled for foot and ankle surgery with calf tourniquet under lateral popliteal sciatic nerve block were randomly assigned to receive 30 mL of either ropivacaine 0.75% or mepivacaine 1.5%. Time required for onset of sensory and motor block, resolution of motor blockade, onset of postsurgical pain, and time of first analgesic medication were recorded.

Results The 2 groups were similar with regard to demographic variables and duration of surgery. Onset of sensory and motor block was significantly shorter in the mepivacaine group (9.9 ± 3.3 min and 14.7 ± 3.6 min, respectively) than in the ropivacaine group (18.1 ± 6.1 min and 23.6 ± 5.5 min, respectively) (P < 0.001). Resolution of motor block occurred later in the ropivacaine group than in the mepivacaine group (P < 0.001), and duration of postoperative analgesia was significantly longer in the ropivacaine group (19 ± 3.4 h) compared with the mepivacaine group (5.9 ± 1.1 h) (P < 0.001). Analgesic requirements were higher in mepivacaine group than in the ropivacaine group (P < 0.001). There were 2 failed blocks, one in each group.

Conclusions Both ropivacaine and mepivacaine provided effective sciatic nerve blockade. Mepivacaine 1.5% displayed a significantly shorter onset time than ropivacaine 0.75%. Postoperatively, ropivacaine 0.75% resulted in longer-lasting analgesia and less need for oral pain medication.

  • Sciatic nerve block
  • Lateral popliteal approach
  • Regional anesthesia
  • Local anesthetics: Ropivacaine
  • Mepivacaine

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