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Korean Journal of Anesthesiology 2002;42(5):646-651.
DOI: https://doi.org/10.4097/kjae.2002.42.5.646   
The Comparison of Ropivacaine and Bupivacaine in Epidural Patient Controlled Analgesia (PCA).
Eun Kyoung Ahn, Jin Ho Kim, Sung Sik Chon, Gee Moon Lee, Myoung Ok Kim, Sang Hwa Kang, In Soon Hwang
1Department of Anesthesiology, National Health Insurance Corporation Ilsan Hospital, Ilsan, Korea. ahnek@nhimc.or.kr
2Department of Anesthesiology, Yonsei University College of Medicine, Seoul, Korea.
Local anesthetics combined with an opiate are frequently used as a postoperative epidural PCA regimen. Ropivacaine is known to have a selective blockade of the sensory nerve without motor blockade. This study is designed to show advantages of ropivacaine over bupivacaine.
Patients undergoing elective abdominal and orthopedic surgeries were randomly selected and divided into two groups, B and R. The patients in group B and R received 0.2% bupivacaine and 0.2% ropivacaine respectively through an epidural catheter using a PCA pump. Both local anesthetic solutions were mixed with 4 microgram/ml of fentanyl. The PCA pumps of both groups were set in the same manner. A basal rate of 2 ml/hr was infused from 1hour after the onset of surgery. This basal rate was continued postoperatively. A bolus dose and lock out time were set at 2 ml and 20 minutes respectively. The Visual analogue pain scale (VAS), demand dose, complication and additional intramuscular analgesic requirements were checked up to 24 hours after surgery in 6-hour interval.
The VAS was significantly lower in group R than in group B at 6, 12, 18 and 24 hours after the surgery (P < 0.05). Total additional bolus doses of the PCA pump were not significantly different in either group at 6, 12, 18 and 24 hours after surgery. The patients in group R showed more satisfaction and less additional intramuscular injections.
0.2% Ropivacaine, mixed with 4microgram/ml of fentanyl, was more effective than bupivacaine, mixed with the same concentration of fentanyl, in controlling postoperative pain using an epidural PCA pump.
Key Words: Analgesia; epidural patient-controlled analgesia; postoperative; fentanyl; ropivacaine; bupivacaine


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