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Epinephrine does not prolong the analgesia of 20 mL ropivacaine 0.5% or 0.2% in a femoral three-in-one block

Published in Anesthesia and analgesia. 2001, vol. 93, no. 5, p. 1327-31
Abstract We tested the effect of epinephrine added to 20 mL ropivacaine 0.5% and 0.2% on postoperative analgesia via a femoral catheter after total knee replacement. Forty-one patients undergoing total knee replacement under combined peripheral block/general anesthesia were randomly allocated to two groups. After insertion of a femoral catheter, 21 patients in the Ropivacaine-Epinephrine (ROPI-EPI) group received 20 mL ropivacaine 0.5% plus epinephrine 1:200,000, whereas 20 patients in the Ropivacaine group (ROPI) received 20 mL plain ropivacaine 0.5%. Thereafter, a sciatic block with 30 mL bupivacaine 0.5% plus epinephrine 1:200,000 was performed in all patients, followed by general anesthesia. After surgery, patient-controlled analgesia (PCA) with ropivacaine 0.2% plus epinephrine 1:200,000 for Group ROPI-EPI and plain ropivacaine 0.2% for Group ROPI was available via the femoral catheter (200 mL ropivacaine 0.2% +/- epinephrine, bolus 20 mL, lockout 120 min). The patients were instructed to use PCA when the knee pain score was >3 cm. The interval between the initial ropivacaine injection and the first PCA injection determined the duration of 20 mL ropivacaine 0.5% +/- epinephrine, whereas the interval between the first and second PCA injection determined the duration of 20 mL ropivacaine 0.2% +/- epinephrine. The average duration of ropivacaine 0.5% was 657 +/- 345 min for the ROPI-EPI group and 718 +/- 423 min for the ROPI group (NS), whereas for ropivacaine 0.2%, the average duration was 409 +/- 245 min for the ROPI-EPI group and 419 +/- 339 min for the ROPI group (not significant). We conclude that epinephrine does not influence the duration of analgesia of the ropivacaine concentrations investigated.
Keywords Acetaminophen/administration & dosageAgedAmides/pharmacologyAnalgesia, Patient-ControlledAnalgesics, Non-Narcotic/administration & dosageAnalgesics, Opioid/administration & dosageAnesthesia, General/methodsAnesthetics, Local/pharmacologyArthroplasty, Replacement, KneeDose-Response Relationship, DrugDouble-Blind MethodDrug InteractionsEpinephrine/pharmacologyFemaleFemoral Nerve/drug effectsHumansMaleMorphine/administration & dosageNerve Block/methodsSciatic Nerve/drug effects
PMID: 11682424
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Research group Chirurgie orthopédique et traumatologique (98)
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WEBER, Anne et al. Epinephrine does not prolong the analgesia of 20 mL ropivacaine 0.5% or 0.2% in a femoral three-in-one block. In: Anesthesia and analgesia, 2001, vol. 93, n° 5, p. 1327-31. doi: 10.1097/00000539-200111000-00060 https://archive-ouverte.unige.ch/unige:48232

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Deposited on : 2015-03-16

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