González SJM, Cedillo MA, Cárdenas JJ, Gómez OI

Language: Spanish
References: 19
Page:
PDF size: 83.38 Kb.

ABSTRACT

The purpose of this experimental comparative clinical investigation was corroborate the 0.5% plain ropivacaine’s efficacy in spinal anesthesia, for patients undergoing lower limb orthopedic surgery, in comparison with 0.5% plain bupivacaine. The age’s rank in the one hundred and forty patients was 18 to 90 years old, with physical status A.S.A. 1 and 2, they were randomly in two groups: Group A (Problem, n=70), spinal anesthesia with 0.5% plain ropivacaine (15 mg.), and Group B (Control, n=70),spinal anesthesia with 0.5% plain bupivacaine (15 mg.). The anesthesia’s quality was evaluated with three parameters: sensitivity level and tourniquet’s tolerance, motor blockade and surgeon’s subjective apreciation. The pneumatic tourniquet was employed in 77.1% (n=108). The anesthesia was adequate in the seventy of the Group B and in sixty eight of the Group A. In two patients of the Group A, the anesthesia was inadequate, p=0.24 with the "Fisher’s exact probability" test. The anesthetic procedure was uneventful in all the patients. Conclusion: the 0.5% plain ropivacaine’s efficacy in spinal anesthesia for patients undergoing lower limb orthopedic surgery is similar to the 0.5% plain bupivavacaine.

REFERENCES

1. Tarkkila P, Habtala J, Salminen U. Difficulties in spinal needle use. Anesthesia 1994; 49:723-5.

2. Robertson DH. Subarachnoid spinal analgesia. Br J Anaesth 1983; 55:1141-7.

3. Hadzic A, Volka JD, Koorn R, Sanborn K, Shih H, Birbanch DJ. The use of regional anesthesia in ambulatory anesthesia practice: Results of a national survey. Anesthesiology 1997; 87(3 ª): A22.

4. Quaymor H, Corbey M, Berg P. Spinal anaesthesia in day case surgery with a 26-gauge needle. Br J Anaesth 1991; 65:776-9.

5. Bion JF. Isobaric bupivacaine for spinal anesthesia in acute war injuries. Anaesthesia 1984; 39:554-9.

6. González SJM, Rivero HS, García CR, Junco CJM, Cárdenas JJ. Anestesia espinal en ancianos para cirugía ortopédica de extremidad inferior. Estudio comparartivo con bupivacaína simple al 0.5% y lidocaína al 5%. Rev. Mex. Anest. 1995; 18:7-10.

7. González SJM, Junco CJM, Cárdenas JJ, Cedillo MA. Dolor por torniquete neumático. Anestesia espinal vs extradural con bupivacaína simple al 0.5% en cirugía ortopédica de extremidad inferior. Rev. Mex. Anest. 1999; 22:17-21.

8. González SJM, Cedillo MA, Cárdenas JJ, Gómez OI, Cortés RNE. Cefalea postpunción en pacientes jóvenes y "ambulatorios", comparando dos tipos de agujas para anestesia espinal en cirugía de extremidad inferior. Rev. Mex. Anest. 2000; 23:161-6.

9. Feldman HS, Covino BG. Comparative motor blocking effects of bupivacaine and ropivacaine, a new amide local anesthetic in the rat and dog. Anesth. Analg. 1988; 67:1047-52.

10. Bannister J, Clark C, Littlewood DG. Ropivacaine: A preliminary clinical trial. Br J Anaesth 1989; 63:237 p.

11. Dusanka Z, Axelson K, Nydahl PA, Philipson L, Jansson JR. Sensory and motor blockade during epidural analgesia with 1%, 0,75% and 0.5% ropivacaine-a double blind study. Anesth. Analg. 1991; 70:509-15.

12. Van Kleef JW, Veering BT, Burn AGL. Spinal anesthesia with ropivacaine: A double blind study on the efficacy and safety of 0.5% and 0.75% solutions in patients undergoing minor lower limb surgery. Anesth Analg 1994; 78:1125-30.

13. Gautier C, de Kock M, van Steenberge A, Poth N, Lahaye-Goffart B, Farnard L, Hody JL. Intrathecal ropivacaine for ambulatory surgery. A comparison between intrathecal ropivacaine for knee arthroscopy. Anesthesiology 1999; 91:1239-45.

14. Cañedo DL. Diseño estadístico de la muestra. En: Cañedo DL. Investigación clínica. Interamericana. México. 1987; 171-83.

15. Mafulli M, Testa V, Capasso G. Use of tourniquet in the internal fixation of fractures of the distal part of the fibula. J Bone Joint Surg 1993; 75:700-3.

16. Pedowitz RA. Tourniquet induced neuromuscular injury. A recent review of a rabbit and clinical experiment. Acta Orthop Scand (suppl.) 1991; 245:1-33.

17. Möller IW, Fernandes A, Edström H. Subarachnoid anaesthesia with 0.5% bupivacaine: effects of density. Br J Anaesth 1984; 56:1191-5.

18. Rosenberg PH, Heinonen E. Differential sensitivity of A and C nerve fibers to long-acting amide local anesthetics. Br J Anaesth 1983; 55:163-7.

19. Morisaki H, Masuda J, Kancko S, Ochiari R, Takeda J. Transiet neurologic sequale in 1045 patients undrergoing spinal anaesthesia with 5% hyperbaric lidocaine. Anesthesiology 1997; 87(3A):A781.