Comparison of Motor Block of 1.0% Ropivacaine and 0.5% Bupivacaine in Epidural Anesthesia for Hip Arthroplasty Surgery.

Kim,  Kyung Hoon; Kim,  Tae Hong; Kim,  Chul Hong; Kwon,  Jae Young; Suh,  Kuen Tak; Chung,  Kyoo Sub

doi:2002.42.4.461

Clinical Research Article

Korean Journal of Anesthesiology 2002;42(4):461-465.
DOI: https://doi.org/10.4097/kjae.2002.42.4.461

Comparison of Motor Block of 1.0% Ropivacaine and 0.5% Bupivacaine in Epidural Anesthesia for Hip Arthroplasty Surgery.

Kyung Hoon Kim, Tae Hong Kim, Chul Hong Kim, Jae Young Kwon, Kuen Tak Suh, Kyoo Sub Chung

¹Department of Anesthesiology, College of Medicine, Pusan National University, Busan, Korea. dolgo@chollian.net
²Department of Orthopedic Surgery, College of Medicine, Pusan National University, Busan, Korea.

Abstract

BACKGROUND
The purpose of this study was to compare the onset time, degree and duration of motor block, and the satisfaction of surgeons of given single epidural injections of 1.0% ropivacaine and 0.5% bupivacaine in patients undergoing hip arthroplasty surgery.
METHODS
In a double-blind randomized study involving 20 patients, patients randomly received 12 ml of 1.0% ropivacaine or 0.5% bupivacaine at the L2 - 3 or L3 - 4 interspace. Parameters measured were the onset time, duration and degree of motor block, and the satisfaction of the surgeons.
RESULTS
Mean onset time of Bromage scale 2 was significantly slower with 1% ropivacaine (14.6 +/- 1.3 min) than with 0.5% bupivacaine (15.7 +/- 2.0 min). However, each frequency of motor blockade (Bromage scale 1, 2 and 3) with 1.0% ropivacaine (10, 8 and 7) was greater than that seen with 0.5% bupivacaine (7, 6 and 1). For scales 1 and 2, 1.0% ropivacaine had a significantly longer duration than 0.5% bupivacaine and the overall duration of motor blockade with 1.0% ropivacaine was longer than 0.5% bupivacaine. Motor block was in 80% achieved satisfactorily of the ropivacaine group and 60% of the bupivacaine group by the surgeons.
CONCLUSIONS
In conclusion this study demonstrated that 1.0% ropivacaine provides a more rapid onset time, greater degree and longer duration of motor block without unacceptable side effects than 0.5% bupivacaine for hip arthroplasty surgery. From these results, it may suggest that 1.0% ropivacaine may be useful for lower extremity orthopedic surgery requiring good muscle relaxation.

Key Words: Bupivacaine; epidural anesthesia; hip arthroplasty; ropivacaine