S. Kampe et al., Postoperative analgesia with no motor block by continuous epidural infusion of ropivacaine 0.1% and sufentanil after total hip replacement, ANESTH ANAL, 89(2), 1999, pp. 395-398
Citations number
12
Categorie Soggetti
Aneshtesia & Intensive Care","Medical Research Diagnosis & Treatment
We assessed the analgesic efficacy of postoperative epidural ropivacaine 0.
1% with and without sufentanil 1 mu g/mL in this prospective, randomized, s
ingle-blinded study of 30 ASA physical status I-III patients undergoing ele
ctive total hip replacement. Lumbar epidural block using 0.75% ropivacaine
was combined with either propofol sedation or general anesthesia for surger
y. After surgery, the epidural infusion was commenced. Fifteen patients in
each group received either an epidural infusion of 0.1% ropivacaine with 1
mu g/mL sufentanil (R+S) or 0.1% ropivacaine without sufentanil (R) at a ra
te of 5-9 mL/h. All patients had access to TV piritramide via a patient-con
trolled analgesia device. The R+S group consumed six times less piritramide
over a 48-h infusion period than the R group (median 12.7 vs 73.0 mg; P <
0.001). Motor block was negligible for the study duration in both groups. P
atient satisfaction was excellent. The incidence of adverse events, such as
nausea, was similar. We conclude that a continuous epidural infusion of 0.
1% ropivacaine with 1 mu g/mL sufentanil is more effective than ropivacaine
alone in treating pain after elective hip replacement without motor block.
Implications: This is the first randomized study comparing the efficacy of
the epidural combination of ropivacaine 0.1% and sufentanil 1 mu g/mL, ver
sus plain ropivacaine 0.1% in treating pain after hip replacement. We found
that ropivacaine 0.1% and sufentanil 1 mu g/mL led to a sixfold reduction
in opioid requirements after total hip replacement by producing a negligibl
e motor block.