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Rivista di Anestesia, Rianimazione, Terapia Antalgica e Terapia Intensiva
Minerva Anestesiologica 2009 Gennaio-Febbraio;75(1-2):7-12
Prospective randomized, blind comparison of ropivacaine and levobupivacaine for superficial plexus anesthesia in carotid endoarterectomy
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.