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BJA Advance Access published online on September 3, 2004
British Journal of Anaesthesia, doi:10.1093/bja/aeh257
© 2004 by The Board of Management and Trustees of the British Journal of Anaesthesia
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Accepted June 10, 2004

Clinical Investigation

Comparison of hyperbaric and plain ropivacaine 15 mg in spinal anaesthesia for lower limb surgery

H. Kallio 1*, E.-V. T. Snäll 1, C. A. Tuomas 1, and P. H. Rosenberg 2

1 Department of Anaesthesia, Forssa Hospital, Forssa, Finland
2 Department of Anaesthesiology and Intensive Care Medicine, Helsinki University Central Hospital, Helsinki, Finland

* To whom correspondence should be addressed. E-mail: helena.kallio{at}fstky.fi.


  Abstract

Background. Previously, plain ropivacaine 15 mg given intrathecally has been shown to be feasible for ambulatory surgery of lower-extremities. Hypothetically, hyperbaric solution could improve and shorten the block.

Methods. This prospective, randomized, double-blind study included 56 patients undergoing surgery of lower extremities. They received intrathecally either 1.5 ml of ropivacaine 10 mg ml-1 and 0.5 ml of glucose 300 mg ml-1 (HYP) or 2 ml of ropivacaine 7.5 mg ml-1 (PL).

Results. All patients in Group HYP achieved T10 dermatome analgesia but only 64% (18/28) of Group PL. T10 analgesia was reached in 5 min (median, range 5-20 min) in the HYP group vs 10 min (5-45 min) in the PL group (P=0.022), and full motor block in 10 min (5-45 min) vs 20 min (5-60 min) (P=0.003), respectively. Group HYP had a longer duration of analgesia at T10; 83 min (5-145 min) vs 33 min (0-140 min) (P=0.004). Duration of sensory block from injection of the anesthetic to complete recovery was shorter in Group HYP than in Group PL, 210 min (120-270 min) vs 270 min (210-360 min) (P<0.001), as was duration of motor block, 120 min (5-150 min) vs 210 min (120-330 min) (P<0.001). Patients of Group HYP attained discharge criteria earlier than those of Group PL (P=0.009).

Conclusion. In comparison with the plain solution, 15 mg of intrathecal hyperbaric ropivacaine produced a faster onset, greater success rate of analgesia at the level of T10 dermatome, and faster recovery of the block.

Keywords: anaesthetic techniques, subarachnoid; anaesthetic techniques, hyperbaric anaesthetics local, ropivacaine.
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