Prospective randomized, blind comparison of ropivacaine and levobupivacaine for superficial plexus anesthesia in carotid endoarterectomy

Minerva Anestesiol. 2009 Jan-Feb;75(1-2):7-12.

Abstract

Background: The authors performed a study to evaluate if the onset time, duration of sensory block, and quality of postoperative analgesia in superficial cervical plexus anesthesia with 0.5% levobupivacaine (1 mg/kg) was greater than 0.75% ropivacaine (1.5 mg/kg).

Design: randomized, double-blind study.

Setting: University teaching hospital.

Participants: 28 consecutive patients undergoing elective carotid thromboendoarterectomy were randomized into two groups.

Interventions: patients received either 1 mg/kg of 0.5% levobupivacaine (N.=15), or 1.5 mg/kg of 0.75% ropivacaine (N.=13). We assessed the onset time (pinprick test), duration of sensory block, and postoperative analgesia with the two drugs.

Results: Onset time of sensory block was 20+/-6 min with ropivacaine and 29+/-8 min with levobupivacaine (P=0.003). Intraoperatively we used different total doses of lidocaine, with the median (interquartile range) dose of 50 (40-100) mg for ropivacaine and 130 (60-180) mg for levobupivacaine (P=0.05). The first pain medication was requested after 12+/-0.4 h by ropivacaine patients and after 11+/-1.6 h by levobupivacaine patients (P=0.5).

Conclusion: No beneficial effect was noted in the quality of nerve block or patient's satisfaction for 0.5% levobupivacaine when compared to 0.75% ropivacaine.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Amides*
  • Anesthetics, Local*
  • Bupivacaine / analogs & derivatives
  • Cervical Plexus
  • Double-Blind Method
  • Endarterectomy, Carotid*
  • Female
  • Hospitals, Teaching
  • Humans
  • Levobupivacaine
  • Male
  • Middle Aged
  • Nerve Block
  • Ropivacaine

Substances

  • Amides
  • Anesthetics, Local
  • Ropivacaine
  • Levobupivacaine
  • Bupivacaine