A double-blind comparison of ropivacaine, bupivacaine, and mepivacaine during sciatic and femoral nerve blockade

Guido Fanelli, Andrea Casati, Paolo Beccaria, Giorgio Aldegheri, Marco Berti, Federica Tarantino, Giorgio Torri

Research output: Contribution to journalArticle

114 Citations (Scopus)

Abstract

No study has evaluated the efficacy of ropivacaine in peripheral nerve block of the lower extremity. The purpose of this prospective, randomized, double-blind study was to compare ropivacaine, bupivacaine, and mepivacaine during combined sciatic-femoral nerve block. Forty-five ASA physical status I or II patients scheduled for elective hallux valgus repair with thigh tourniquet were randomized to receive combined sciatic-femoral block with 0.75% ropivacaine (ROPI, n = 15), 0.5% bupivacaine (BUPI, n = 15), and 2% mepivacaine (MEPI, n = 15). Time required for onset of sensory and motor block on the operated limb (readiness for surgery) and resolution of motor block, as well as onset of postsurgical pain and time of first analgesic requirement, were recorded. The three groups were similar with regard to demographic variables, duration of surgery, and measured visual analog pain scores. Onset of sensory and motor blockade was similar in Groups ROPI and MEPI and significantly shorter than in Group BUPI (P = 0.002 and P = 0.001, respectively). Resolution of motor block occurred later in Groups ROPI and BUPI than in Group MEPI (P = 0.005 and P = 0.0001, respectively). Duration of postoperative analgesia was significantly longer in Groups ROPI (670 ± 227 min) and BUPI (880 ± 312 min) compared with Group MEPI (251 ± 47 min) (P = 0.0001), with a significant decrease in postoperative pain medication requirements (P <0.05). We conclude that for sciatic-femoral nerve block, 0.75% ropivacaine has an onset similar to that of 2% mepivacaine and a duration of postoperative analgesia between that of 0.5% bupivacaine and 2% mepivacaine. Implications: Quick onset of block with prolonged postoperative analgesia is an important goal in peripheral nerve blockade. We evaluated the clinical properties of 0.5% bupivacaine, 2% mepivacaine, and 0.75% ropivacaine for sciatic-femoral nerve block and demonstrated that ropivacaine has an onset similar to that of mepivacaine but allows for postoperative analgesia between that of bupivacaine and mepivacaine.

Original languageEnglish
Pages (from-to)597-600
Number of pages4
JournalAnesthesia and Analgesia
Volume87
Issue number3
Publication statusPublished - 1998

Fingerprint

Mepivacaine
Femoral Nerve
Nerve Block
Bupivacaine
Sciatic Nerve
Analgesia
Thigh
Peripheral Nerves
Hallux Valgus
Pain
Tourniquets
Postoperative Pain
ropivacaine
Double-Blind Method
Analgesics
Lower Extremity
Extremities
Demography

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Fanelli, G., Casati, A., Beccaria, P., Aldegheri, G., Berti, M., Tarantino, F., & Torri, G. (1998). A double-blind comparison of ropivacaine, bupivacaine, and mepivacaine during sciatic and femoral nerve blockade. Anesthesia and Analgesia, 87(3), 597-600.

A double-blind comparison of ropivacaine, bupivacaine, and mepivacaine during sciatic and femoral nerve blockade. / Fanelli, Guido; Casati, Andrea; Beccaria, Paolo; Aldegheri, Giorgio; Berti, Marco; Tarantino, Federica; Torri, Giorgio.

In: Anesthesia and Analgesia, Vol. 87, No. 3, 1998, p. 597-600.

Research output: Contribution to journalArticle

Fanelli, G, Casati, A, Beccaria, P, Aldegheri, G, Berti, M, Tarantino, F & Torri, G 1998, 'A double-blind comparison of ropivacaine, bupivacaine, and mepivacaine during sciatic and femoral nerve blockade', Anesthesia and Analgesia, vol. 87, no. 3, pp. 597-600.
Fanelli G, Casati A, Beccaria P, Aldegheri G, Berti M, Tarantino F et al. A double-blind comparison of ropivacaine, bupivacaine, and mepivacaine during sciatic and femoral nerve blockade. Anesthesia and Analgesia. 1998;87(3):597-600.
Fanelli, Guido ; Casati, Andrea ; Beccaria, Paolo ; Aldegheri, Giorgio ; Berti, Marco ; Tarantino, Federica ; Torri, Giorgio. / A double-blind comparison of ropivacaine, bupivacaine, and mepivacaine during sciatic and femoral nerve blockade. In: Anesthesia and Analgesia. 1998 ; Vol. 87, No. 3. pp. 597-600.
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abstract = "No study has evaluated the efficacy of ropivacaine in peripheral nerve block of the lower extremity. The purpose of this prospective, randomized, double-blind study was to compare ropivacaine, bupivacaine, and mepivacaine during combined sciatic-femoral nerve block. Forty-five ASA physical status I or II patients scheduled for elective hallux valgus repair with thigh tourniquet were randomized to receive combined sciatic-femoral block with 0.75{\%} ropivacaine (ROPI, n = 15), 0.5{\%} bupivacaine (BUPI, n = 15), and 2{\%} mepivacaine (MEPI, n = 15). Time required for onset of sensory and motor block on the operated limb (readiness for surgery) and resolution of motor block, as well as onset of postsurgical pain and time of first analgesic requirement, were recorded. The three groups were similar with regard to demographic variables, duration of surgery, and measured visual analog pain scores. Onset of sensory and motor blockade was similar in Groups ROPI and MEPI and significantly shorter than in Group BUPI (P = 0.002 and P = 0.001, respectively). Resolution of motor block occurred later in Groups ROPI and BUPI than in Group MEPI (P = 0.005 and P = 0.0001, respectively). Duration of postoperative analgesia was significantly longer in Groups ROPI (670 ± 227 min) and BUPI (880 ± 312 min) compared with Group MEPI (251 ± 47 min) (P = 0.0001), with a significant decrease in postoperative pain medication requirements (P <0.05). We conclude that for sciatic-femoral nerve block, 0.75{\%} ropivacaine has an onset similar to that of 2{\%} mepivacaine and a duration of postoperative analgesia between that of 0.5{\%} bupivacaine and 2{\%} mepivacaine. Implications: Quick onset of block with prolonged postoperative analgesia is an important goal in peripheral nerve blockade. We evaluated the clinical properties of 0.5{\%} bupivacaine, 2{\%} mepivacaine, and 0.75{\%} ropivacaine for sciatic-femoral nerve block and demonstrated that ropivacaine has an onset similar to that of mepivacaine but allows for postoperative analgesia between that of bupivacaine and mepivacaine.",
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AU - Tarantino, Federica

AU - Torri, Giorgio

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N2 - No study has evaluated the efficacy of ropivacaine in peripheral nerve block of the lower extremity. The purpose of this prospective, randomized, double-blind study was to compare ropivacaine, bupivacaine, and mepivacaine during combined sciatic-femoral nerve block. Forty-five ASA physical status I or II patients scheduled for elective hallux valgus repair with thigh tourniquet were randomized to receive combined sciatic-femoral block with 0.75% ropivacaine (ROPI, n = 15), 0.5% bupivacaine (BUPI, n = 15), and 2% mepivacaine (MEPI, n = 15). Time required for onset of sensory and motor block on the operated limb (readiness for surgery) and resolution of motor block, as well as onset of postsurgical pain and time of first analgesic requirement, were recorded. The three groups were similar with regard to demographic variables, duration of surgery, and measured visual analog pain scores. Onset of sensory and motor blockade was similar in Groups ROPI and MEPI and significantly shorter than in Group BUPI (P = 0.002 and P = 0.001, respectively). Resolution of motor block occurred later in Groups ROPI and BUPI than in Group MEPI (P = 0.005 and P = 0.0001, respectively). Duration of postoperative analgesia was significantly longer in Groups ROPI (670 ± 227 min) and BUPI (880 ± 312 min) compared with Group MEPI (251 ± 47 min) (P = 0.0001), with a significant decrease in postoperative pain medication requirements (P <0.05). We conclude that for sciatic-femoral nerve block, 0.75% ropivacaine has an onset similar to that of 2% mepivacaine and a duration of postoperative analgesia between that of 0.5% bupivacaine and 2% mepivacaine. Implications: Quick onset of block with prolonged postoperative analgesia is an important goal in peripheral nerve blockade. We evaluated the clinical properties of 0.5% bupivacaine, 2% mepivacaine, and 0.75% ropivacaine for sciatic-femoral nerve block and demonstrated that ropivacaine has an onset similar to that of mepivacaine but allows for postoperative analgesia between that of bupivacaine and mepivacaine.

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