F-RESPONSE AND H-REFLEX FOR MONITORING NERVE BLOCK DURING EPIDURAL ANALGESIA WITH ROPIVACAINE

The effect of a single epidural injection of ropivacaine on the motor and sensory function controlled from the L5/S1 level was investigated in 28 male volunteers. Concentrations of 1%, 0.75%, or 0.5% ropivacain e, 20 mL, administered at the L2/3 level were studied. Motor function was assessed quantitatively (measurement of muscle force by mechano-tr ansducers), and sensory function by the pinprick method. In addition, F response and H reflex, tests which measure the conduction velocity i n the central parts of peripheral nerves, were used. Epidural ropivaca ine caused dose-dependent prolongation of the latencies of both these variables. F response latency recovered significantly later than motor function measured by mechano-transducers in the two lower concentrati on groups. H reflex latency recovered significantly later than sensory function assessed by the pinprick method in all three concentration g roups. The time needed for recovery of F and H latencies was not signi ficantly longer than the time from epidural injection to mobilization. At the time when the subjects could go through the mobilization proce dure, 12 of 28 subjects were not completely recovered. In 5 of these 1 2 subjects, the H reflex latency was persistently prolonged at the end of the investigation, long after the subjects felt ''normal'' again. On follow-up recordings 5 mo later, the baseline latency had been rega ined in all five subjects. We conclude that F response and H reflex la tencies are good indicators of the inhibition of nerve impulse conduct ion induced by epidural analgesia.