4 resultados para Ropivacaina


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Background and Objectives - Ropivacaine - a local amino amide anesthetic agent - is a plain S enantiomer which makes it a potent and low toxicity drug. The aim of our study was to evaluate 1% ropivacaine for epidural block in lower doses than those described in the literature. Methods - Thirty-eight patients, physical status ASA I and II, aged 15 to 70 years, weighing 50 to 100 kg were selected. Premedication consisted of 15 mg oral midazolam given 60 min before anesthesia induction. In the OR, after standard monitoring a catheter was inserted intravenously to administer 10 ml.kg-1 Ringers lactate solution. Epidural puncture was performed with the patient in the sitting position and 1% ropivacaine was administered in a volume corresponding to 10% of patient's height in centimeters. With the patient in the supine position, motor blockade intensity, temperature sensitivity and sensory block extension at 1, 3, 5, 7, 10, 15, 20, 30 minutes after drug injection were evaluated. Blood pressure, heart rate and adverse side effects during the course of anesthesia and in the post-anesthetic period were also observed. In the recovery room patients were followed-up until motor blockade intensity temperature sensitivity and sensory block had returned to level L2. Results - Mean values were 41.4 years of age, 68.8 kg of body weight and 165 cm height. Upper thermal blockade level was T4 and upper sensory block level was T6. Most patients showed motor block level 1 (Bromage scale) after 30 minutes of observation. Motor block mean duration was 254 minutes and temperature sensitivity 426 minutes. Only three patients had complications: two cases of hypotension and one of bradycardia. Conclusions - In the volumes used in this study, ropivacaine produced adequate analgesia and a less intense lower limb motor block which, however, was sufficient to allow for surgical procedures with low incidence of side-effects.

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BACKGROUND: Patient-controlled epidural analgesia with low concentrations of anesthetics is effective in reducing labor pain. The aim of this study was to assess and compare two ultra-low dose regimens of ropivacaine and sufentanil (0.1% ropivacaine plus 0.5 μg.ml-1 sufentanil vs. 0.06% ropivacaine plus 0.5 μg.ml-1 sufentanil) on the intervals between boluses and the duration of labor. MATERIAL AND METHODS: In this non-randomized prospective study, conducted between January and July 2010, two groups of parturients received patient-controlled epidural analgesia: Group I (n = 58; 1 mg.ml-1 ropivacaine + 0.5 μg.ml-1 sufentanil) and Group II (n = 57; 0.6 mg.ml-1 ropivacaine + 0.5 μg.ml-1 sufentanil). Rescue doses of ropivacaine at the concentration of the assigned group without sufentanil were administered as necessary. Pain, local anesthetic requirements, neuraxial blockade characteristics, labor and neonatal outcomes, and maternal satisfaction were recorded. RESULTS: The ropivacaine dose was greater in Group I (9.5 [7.7-12.7] mg.h-1 vs. 6.1 [5.1-9.8 mg.h-1], p < 0.001). A time increase between each bolus was observed in Group I (beta = 32.61 min, 95% CI [25.39; 39.82], p < 0.001), whereas a time decrease was observed in Group II (beta = -1.40 min, 95% CI [-2.44; -0.36], p = 0.009). The duration of the second stage of labor in Group I was significantly longer than that in Group II (78 min vs. 65 min, p < 0.001). CONCLUSIONS: Parturients receiving 0.06% ropivacaine exhibited less evidence of cumulative effects and exhibited faster second stage progression than those who received 0.1% ropivacaine.

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The aim of this study was to investigate the use of ropivacaine combined or not with different opioids, for epidural anesthesia in bitches submitted to elective ovariosalpingohisterectomy (OSH). Thirty two mixed-breed female dogs, adults were used with medium weigh of 10.5kg. The animals were premedicated with acepromazine (0.05mg.kg-1, IM) and midazolam (0.2mg.kg-1, IM) and allocated in four experimental groups: group 1(n=8): ropivacaine: 0.3 mL.kg-1; group 2(n=8): ropivacaine + morphine (0.1 mg.kg-1); group 3(n=8): ropivacaine + butorphanol (0.1 mg.kg-1); and group 4(n=8): ropivacaine + tramadol (0.5 mg.kg-1) administered epidurally. Heart and respiratory rate; systolic arterial pressure; rectal temperature; arterial blood gas partial pressures; blood pH; sedation and muscular relaxation degree were evaluated at different experimental moments. The data were submitted to ANOVA and compared by Kruskal Wallis, Friedman, Dunn, Tukey and Chi-square test (p≤0.05). Minimum cardiorespiratory alterations were observed and the group of the ropivacaíne combined with the butorphanol (G3) presented a more cranial blockage, what allowed the accomplishment of OSH without induction in six animals (75%) whereas most of the others needed anesthetic rescue. The results allow us to conclude that the use of ropivacaine sole or combinated with morphine, butorphanol or tramadol, for epidural anesthesia, didn't promote significant cardiorrespiratory depression and the ropivacaine associated to the butorphanol allowed the accomplishment of OSH in bitches.