British Journal of Anaesthesia, Vol 80, Issue 5 680-681, Copyright © 1998 by The Board of Management and Trustees of the British Journal of Anaesthesia
T. Muldoon, K. Milligan, P. Quinn, D. C. Connolly and K. Nilsson
We have compared the analgesia and motor block produced by extradural
infusions of ropivacaine and bupivacaine after total knee arthroplasty.
Fifty-two patients received 8 ml h1 of either 0.2% ropivacaine or 0.2%
bupivacaine by extradural infusion for 24 h after operation. Analgesia was
assessed by postoperative visual analogue scale (VAS) and morphine
consumption. At rest these were low in both groups; median VAS was 0- 13.3
mm for the ropivacaine group and 0-0.5 mm for the bupivacaine group. Over
the 24 h of the infusion, the estimated (ropivacaine bupivacaine)
difference in wound pain at rest was 5.6 mm (P = 0.017) and on passive
movement 11.6 mm (P = 0.016). Median morphine consumption was 30.7 mg in
the ropivacaine group and 20.5 mg in the bupivacaine group. In the
ropivacaine group, 50% of patients compared with 19% in the bupivacaine
group had no motor block 2 h after operation, increasing to 88% for
ropivacaine and 56% for bupivacaine by 24 h. Bupivacaine produced
significantly more frequent and intense motor block over the 24 h (P =
0.015).
SHORT COMMUNICATIONS
Comparison between extradural infusion of ropivacaine or bupivacaine for the prevention of postoperative pain after total knee arthroplasty
Department of Anaesthetics, Queens University Belfast and Musgrave Park Hospital, Belfast, N. Ireland; Astra Pain Control AB, Sodertalje, Sweden
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