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British Journal of Anaesthesia, 2003, Vol. 91, No. 1 155-157
© 2003 The Board of Management and Trustees of the British Journal of Anaesthesia

Correspondence

Spinal anaesthesia: a comparison of plain ropivacaine 5 mg ml–1 with bupivacaine 5 mg ml–1 for major orthopaedic surgery

T. M. Cook1, D.A. McNamee2, K. R. Milligan2, L. Westman3 and U. Gustaffson3

1 Bath, UK 2 Belfast, UK 3 Sodertalje, Sweden

The first 10% of the full text of this article appears below.

Editor—I am interested in the article by McNamee and colleagues1 comparing the use of plain bupivacaine 0.5% with plain ropivacaine 0.5% during spinal anaesthesia for orthopaedic surgery. Both groups received 3.5 ml of 0.5% of the chosen local anaesthetic.

The authors report spinal blockade with a median sensory block of T2 in the bupivacaine group and T3 in the ropivacaine group. They report ‘moderate fall in arterial blood pressure in keeping with expected sympathetic block’. Hypotension requiring ephedrine in the two groups occurred in 12 and 26% of patients, respectively. Up to ephedrine 35 mg was required in patients in either group. Adverse events included oliguria, hypotension and nausea, although incidences are not reported. The high levels of sensory blockade are considered as acceptable and part of the consequences of regional anaesthesia in elderly patients. I . . . [Full Text of this Article]


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