Background and Objectives: Several investigators have described the effect of bolus injections on sensory block during combined spinal epidural anesthesia. This study investigates the effects of the immediate epidural infusion of 0.2% ropivacaine versus 0.9% saline on spinal anesthesia.
Methods: Forty-four patients undergoing partial hip replacement were randomly assigned to 2 groups, receiving epidural infusion of 0.2% ropivacaine 10 mL/h (group R, n = 22) or 0.9% NaCl 10 mL/h (group S, n = 22), immediately after spinal anesthesia with 7.5 mg 0.5% hyperbaric bupivacaine. Postoperative analgesia was provided in both groups using a ropivacaine patient-controlled epidural analgesia technique. Sensory block, motor block, postoperative pain scores, ropivacaine consumption, and patient satisfaction were recorded.
Results: There was no difference between the 2 groups in the characteristics of the sensory block. The duration of motor block was prolonged in group R (312 ± 95 minutes vs 198 ± 78 minutes; P < .001). Postoperative pain scores and 24-hour ropivacaine consumption were similar among groups. Demand/delivery ratio was 1.6 in group R and 3.5 in group S (P = .048). A significantly higher number of patients in group R described their satisfaction as excellent (20 patients vs 6 patients; P < .001).
Conclusions: Epidural infusion of ropivacaine 0.2% initiated immediately after spinal anesthesia prolonged the regression of motor block but not the regression of sensory block when compared with saline infusion.
- Combined spinal epidural anesthesia
- Epidural top-up
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Reprint requests: Murat Yasar Ozkalkanli, M.D., Izmir Ataturk Training Research Hospital, Department of Anesthesiology and Reanimation, Basinsitesi, Izmir 35000, Turkey. E-mail:
This study was performed in Izmir Ataturk Training Research Hospital, with the financial support of the Izmir Ataturk Training Research Hospital Fund. This work was presented, in part, as a Poster, in the Euroanaesthesia Congress 2006, 3-6 June 2006, Madrid, Spain.