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Sciatic nerve block with 0.5% levobupivacaine, 0.75% levobupivacaine or 0.75% ropivacaine: a double-blind, randomized comparison

Published online by Cambridge University Press:  02 June 2005

A. Casati ,
F. Vinciguerra ,
R. Santorsola ,
G. Aldegheri ,
M. Putzu  and
G. Fanelli
A. Casati
Affiliation:
University of Parma, Department of Anaesthesia, Analgesia, and Pain Therapy, Hospital of Parma, Parma, Italy
F. Vinciguerra
Affiliation:
Vita-Salute University of Milano, Department of Anaesthesiology, IRCCS H. San Raffaele, Milan, Italy
R. Santorsola
Affiliation:
Vita-Salute University of Milano, Department of Anaesthesiology, IRCCS H. San Raffaele, Milan, Italy
G. Aldegheri
Affiliation:
Vita-Salute University of Milano, Department of Anaesthesiology, IRCCS H. San Raffaele, Milan, Italy
M. Putzu
Affiliation:
University of Parma, Department of Anaesthesia, Analgesia, and Pain Therapy, Hospital of Parma, Parma, Italy
G. Fanelli
Affiliation:
University of Parma, Department of Anaesthesia, Analgesia, and Pain Therapy, Hospital of Parma, Parma, Italy
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Summary

Background and objective: This prospective, randomized, double-blind study was conducted to evaluate the onset time and duration of sciatic nerve block produced with 0.5% levobupivacaine, 0.75% levobupivacaine and 0.75% ropivacaine.

Methods: Forty-five healthy patients undergoing hallux valgus repair were randomly allocated to receive sciatic nerve block with levobupivacaine 0.5% (n = 15), levobupivacaine 0.75% (n = 15) or ropivacaine 0.75% 20 mL (n = 15). A femoral nerve block was also performed with mepivacaine 2% 15 mL to cover pain related to the thigh tourniquet. A blinded observer recorded the onset time and duration of sciatic nerve block.

Results: The median (range) onset time was 5 (5–40) min with 0.75% levobupivacaine, 30 (5–60) min with 0.5% levobupivacaine and 20 (5–50) min with 0.75% ropivacaine (P = 0.02 and P = 0.12, respectively). Mean (25–75 percentiles) first request for pain medication occurred after 13 (11–14) h with 0.75% ropivacaine, 18 (15–19) h with 0.75% levobupivacaine and 16 (13–20) h with 0.5% levobupivacaine (P = 0.002 and P = 0.002, respectively). Rescue tramadol after surgery was required by three patients in the 0.75% levobupivacaine group, eight patients in the 0.5% levobupivacaine group and nine patients in the 0.75% ropivacaine group (P = 0.05).

Conclusions: We conclude that 0.75% levobupivacaine provides a shorter onset time than 0.5% levobupivacaine and a longer duration of postoperative analgesia than both 0.5% levobupivacaine and 0.75% ropivacaine with reduced need for rescue analgesia after surgery.

Keywords

ANAESTHETIC TECHNIQUES, REGIONAL, sciatic nerve blockANAESTHETIC, LOCAL, ropivacaine, levobupivacaineSURGERY, ORTHOPAEDIC, hallux valgus repair
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 22 , Issue 6 , June 2005 , pp. 452 - 456
Copyright
© 2005 European Society of Anaesthesiology

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