CONTINUOUS EPIDURAL ROPIVACAINE 0.2-PERCENT FOR ANALGESIA AFTER LOWERABDOMINAL-SURGERY

The purpose of this study was to determine whether a lumbar epidural i nfusion of ropivacaine 0.2% would provide effective analgesia with an acceptably low incidence of motor blockade and side effects after lowe r abdominal surgery. After combined general and epidural anesthesia an d surgery, 125 patients were randomly assigned to receive either salin e or ropivacaine 0.2% at a rate of 6, 8, 10, 12, or 14 mL/h (Groups R6 , R8, R10, R12, and R14, respectively) for 21 h. Supplemental analgesi a, if required, was provided with intravenous patient-controlled analg esia with morphine. Data were collected at 4, 8, and 21 h, and include d morphine consumption, pain scores at rest and with coughing, motor a nd sensory block, and adverse events. Cumulative morphine consumption was less in Groups R10, R12, and R14 compared with the saline group. A t 4 h analgesia was better among patients receiving ropivacaine, but a t 21 h pain scores were identical. Sensory blockade at 8 and 21 h was greater in the ropivacaine groups compared with the saline group. Appr oximately 30% of R8, R10, and R12 patients, and 63% of R14 patients ha d demonstrable motor block of the lower limbs at 21 hours. We conclude that lumbar epidural ropivacaine 0.2% reduces parenteral morphine req uirements but has little effect on pain scores and may be associated w ith motor blockade.