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Online ISSN 1827-1596
Messina M., Magrin S., Bignami E., Maj G., Carozzo A., Mennella R., Landoni G., Zangrillo A.
Department of Cardiothoracic and Vascular Anesthesia, San Raffaele Vita-Salute University, Milan, Italy; 2San Raffaele Scientific Institute, Milan, Italy
Background. The authors performed a study to evaluate if the onset time, duration of sensory block, and quality of postoperative analgesia in superficial cervical plexus anesthesia with 0.5% levobupivacaine (1 mg/kg) was greater than 0.75% ropivacaine (1.5 mg/kg).
Methods. Design: randomized, double-blind study. Setting: University teaching hospital. Participants: 28 consecutive patients undergoing elective carotid thromboendoarterectomy were randomized into two groups. Interventions: patients received either 1 mg/kg of 0.5% levobupivacaine (N.=15), or 1.5 mg/kg of 0.75% ropivacaine (N.=13). We assessed the onset time (pinprick test), duration of sensory block, and postoperative analgesia with the two drugs.
Results. Onset time of sensory block was 20±6 min with ropivacaine and 29±8 min with levobupivacaine (P=0.003). Intraoperatively we used different total doses of lidocaine, with the median (interquartile range) dose of 50 (40-100) mg for ropivacaine and 130 (60-180) mg for levobupivacaine (P=0.05). The first pain medication was requested after 12±0.4 h by ropivacaine patients and after 11±1.6 h by levobupivacaine patients (P=0.5).
Conclusion. No beneficial effect was noted in the quality of nerve block or patient’s satisfaction for 0.5% levobupivacaine when compared to 0.75% ropivacaine.