British Journal of Anaesthesia, Vol 76, Issue 5 606-610, Copyright © 1996 by The Board of Management and Trustees of the British Journal of Anaesthesia
G. Turner, D. Blake, M. Buckland, D. Chamley, P. Dawson, C. Goodchild, J. Mezzatesta, D. Scott, A. Sultana, S. Walker, M. Hendrata, P. Mooney and M. Armstrong
We studied 151 patients undergoing total hip or knee arthroplasty, or
cruciate ligament reconstruction in a multicentre study in Australia and
New Zealand. Patients were openly allocated randomly to one of five
treatment groups or to a control group. General anaesthesia was induced
after introduction of extradural block with 0.5% ropivacaine. After
surgery, patients received an extradural infusion of 0.2% ropivacaine at 6,
8, 10, 12 or 14 ml h-1 or received no postoperative extradural infusion
(control group). All patients had access to i.v. PCA morphine for
supplementary analgesia. Morphine consumption was lower in all treatment
groups compared with the control group, decreasing with increasing
ropivacaine infusion rate. Median VAS scores were lower in all ropivacaine
infusion groups compared with the control group for the first 10 h of the
study; however by the end of the study, VAS scores were similar in all
groups. The higher ropivacaine infusion rates caused a slower convergence
of spread of the initial sensory block and a higher degree of motor block.
The overall incidence of side effects was similar, with the exception of a
higher incidence of urinary retention and hypotension in the groups
receiving the higher rates of ropivacaine. The quality of treatment scores
were similar for all treatment groups.
CLINICAL INVESTIGATIONS
Continuous extradural infusion of ropivacaine for prevention of postoperative pain after major orthopaedic surgery
Royal Perth Hospital, Perth, WA, Australia; Royal Melbourne Hospital, Melbourne, Vic, Australia; Alfred Hospital, Melbourne, Vic, Australia; Middlemore Hospital, Auckland, New Zealand; Monash Medical Centre, Melbourne, Vic, Australia; St Vincent's Hospital, Melbourne, Vic, Australia
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