Analgezja zewnątrzoponowa 1% ropiwakainą do operacji wymiany stawu biodrowego

Edyta Kotlińska-Hasiec, Andrzej Nestorowicz, Katarzyna Kuchnicka, Artur Florek, Marcin Kopieniak, Wojciech Dąbrowski

Summary
Background. Ropivacaine is less cardiotoxic than bupivacaine but produces less motor block. We have assessed the efficacy of 1% epidural ropivacaine for hip replacement surgery, Methods. We prospectively studied 20 patients, aged 42-76 years receiving epidural anaesthesia with 12.0 ± 4.25 ml of 1% ropivacaine for elective procedures. We evaluated onset time, extension and regression of sensory and motor block, heart rate, arterial blood pressure and pulse oximetry. Results. Extent of the block ranged from Th₆-Th₁₂. The motor block was assessed using a Bromage score, and was rated as 2^nd degree in 10 patients, and 3^rd degree in the remaing 10. Clinically relevant hypotension (a fall of> 20% of initial value) was noted in 7 patients, and cardiac arrhythmia occurred in one case. Conclusions. Although ropivacaine causes less motor block than bupivacaine and has not been recommended for orthopaedic procedures, we found that the degree of muscle relaxation achieved with increased concentration of the drug provided analgesia and motor block, sufficient for hip replacement surgery, without significant cardiovascular compromise.

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