Morrison-L-M. Emanuelsson-B-M. McClure-J-H. Pollok-A-J.
McKeown-D-W. Brockway-M. Jozwiak-H. Wildsmith-J-A.
Efficacy and kinetics of extradural ropivacaine:
comparison with bupivacaine.
Br-J-Anaesth. 1994 Feb. 72(2). P 164-9.
Ninety-one patients were allocated randomly to three
groups to
receive 1% ropivacaine 10 ml, 0.5% ropivacaine 20
ml or 0.5% bupivacaine 20 ml extradurally. Intermittent sensory
(pinprick) and motor (Bromage scale) assessments of the block
produced were recorded, with an assessment of the quality of
the block and the requirement for supplementary analgesia.
There was little difference between the groups in frequency,
onset, duration or spread of sensory block. However, the motor
block produced by 0.5% ropivacaine was less intense and
of shorter duration than that with bupivacaine. The block
produced by the smaller volume of ropivacaine was less
reliable clinically than the larger, more dilute, solution and
more anaesthetic supplements were required in that group.
Cardiovascular changes were similar in all three groups. The
peak plasma concentration of ropivacaine was
significantly greater and T1/2 significantly shorter than those
of bupivacaine, although no patient showed any features of
systemic toxicity. The systemic kinetics of ropivacaine
were not influenced significantly by varying the concentration
or volume administered.