Brachial plexus block with a new local anaesthetic: 0.5 per cent ropivacaine.
A new local anaesthetic, ropivacaine hydrochloride, was used in a concentration of 0.5 per cent in 32 patients receiving a subclavian perivascular block for upper extremity surgery. One group (n = 15) received 0.5 per cent ropivacaine without epinephrine and a second group (n = 17) received 0.5 per cent ropivacaine with epinephrine in a concentration of 1:200,000. Anaesthesia was achieved in 87 per cent of the patients in both groups in all of the C5 through T1 brachial plexus dermatomes. Motor block was profound with 100 per cent of patients in both groups developing paresis at both the shoulder and hand and 100 per cent developing paralysis at the shoulder. There was a rapid initial onset of sensory block (a mean of less than four minutes for analgesia) with a prolonged duration (a mean of greater than 13 hr of analgesia). The addition of epinephrine did not significantly affect the quality or onset of sensory or motor block. The duration of sensory block was reduced by epinephrine at T1 for analgesia and at C7, C8, and T1 for anaesthesia. The duration of sensory block in the remaining brachial plexus dermatomes as well as the duration of motor block was not effected by epinephrine. There was no evidence of cardiovascular or central nervous system toxicity in either group with a mean dose of 2.5-2.6 mg.kg-1 ropivacaine.
Hickey
R
R
Department of Anesthesiology, University of Texas, Health Science Center, San Antonio 78284.
Candido
K D
KD
Ramamurthy
S
S
Winnie
A P
AP
Blanchard
J
J
Raza
S M
SM
Hoffman
J
J
Durrani
Z
Z
Masters
R W
RW
D000328:Adult; D000577:Amides / Q000008:administration & dosage / Q000494:pharmacology; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000494:pharmacology; D001917:Brachial Plexus / Q000187:drug effects; D002572:Cervical Plexus / Q000187:drug effects; D004837:Epinephrine / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008297:Male; D009046:Motor Neurons / Q000187:drug effects; D009407:Nerve Block; D010243:Paralysis / Q000503:physiopathology; D000077212:Ropivacaine; D012677:Sensation / Q000187:drug effects; D012782:Shoulder; D013997:Time Factors
D000577:Amides; D000779:Anesthetics, Local; D000077212:Ropivacaine; D004837:Epinephrine