Title: A comparison of efficacy of continuous epidural infusion of 0.2% levobupivacaine and 0.2% ropivacaine for postoperative pain relief
Abstract: Objective To investigate the analgesic efficacy and safety of continuous epidural infusion of 0.2% levobupivacaine in patients after lower abdominal surgery.Methods Sixty ASA Ⅰ - Ⅱ patients undergoing lower abdominal gynecologic operation under epidural anesthesia were randomly divided into two groups : group L levobupivacaine (n = 30) and group R ropivacaine ( n = 30) . An epidural catheter was placed at L2-3 . After operation the catheter was connected through a 3-way Stopcock to a Graseby 9 500 infusion pump for continuous infusion of 0.2% levobupivacaine or 0.2% ropivacaine at a rate of 4 ml·h-1 and a Graseby 3300 infusion pump for PCEA with 0.01% morphine (bolus dose = 2ml, lockout interval = 10 min, total dose limit = 16 ml·4 h-1) (1) VAS score (0 = no pain, 100 = severe pain). (2) the ratio of the number of attempts calculated (D1) to the number of successfully delivered doses (D2) (D1/D2), (3) modified Bromage Motor scale score, (4) Bruggmann comfort scale (BCS), (5) Ramsay sedation score and (6) the severity of side effects were recorded 0, 2,4, 8, 12, 20 and 24h after operation.Results The demographic data (age, body weight, height) and duration of operation were comparable between the two groups. The analgesia was satisfactory in both groups. VAS scores were significantly lower in levobupivacaine group than that in ropivacaine group at 8 and 24 h after operation ( P 0.05). There was no significant difference in BCS and Ramsay score between the two groups. There were 7 patients in group L (23%) and 5 patients in group R (17% ) in whom no PCEA was used. The time required for recovery of motor function was significantly longer in group L (7.8 ±2.8h) than that in group R (5.9 ± 2.5h). The Bromage score was higher in group L (1.3 ± 0.9) than that in group R (1.1 ± 1.0) at 4h after operation.Conclusion Background epidural infusion of 0.2% levobupivacaine + PCEA with 0.01% morphine is satisfactory for postoperative analgesia. The motor block produced by 0.2% levobupivacaine is more intense than by 0.2 % ropivacaine.
Publication Year: 2004
Publication Date: 2004-01-01
Language: en
Type: article
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