title: Comparison of hyperbaric and plain ropivacaine 15 mg in spinal anaesthesia for lower limb surgery.
abstract: BACKGROUND
  Previously, plain ropivacaine 15 mg given intrathecally has been shown to be feasible for ambulatory surgery of lower-extremities. Hypothetically, hyperbaric solution could improve and shorten the block.
  
  
  METHODS
  This prospective, randomized, double-blind study included 56 patients undergoing surgery of lower extremities. They received intrathecally either 1.5 ml of ropivacaine 10 mg ml(-1) and 0.5 ml of glucose 300 mg ml(-1) (HYP) or 2 ml of ropivacaine 7.5 mg ml(-1) (PL).
  
  
  RESULTS
  All patients in Group HYP achieved T(10) dermatome analgesia but only 64% (18/28) of Group PL. T(10) analgesia was reached in 5 min (median, range 5-20 min) in the HYP group vs 10 min (5-45 min) in the PL group (P=0.022), and full motor block in 10 min (5-45 min) vs 20 min (5-60 min) (P=0.003), respectively. Group HYP had a longer duration of analgesia at T(10); 83 min (5-145 min) vs 33 min (0-140 min) (P=0.004). Duration of sensory block from injection of the anesthetic to complete recovery was shorter in Group HYP than in Group PL, 210 min (120-270 min) vs 270 min (210-360 min) (P<0.001), as was duration of motor block, 120 min (5-150 min) vs 210 min (120-330 min) (P<0.001). Patients of Group HYP attained discharge criteria earlier than those of Group PL (P=0.009).
  
  
  CONCLUSIONS
  In comparison with the plain solution, 15 mg of intrathecal hyperbaric ropivacaine produced a faster onset, greater success rate of analgesia at the level of T(10) dermatome, and faster recovery of the block.
authors.affiliation: Department of Anaesthesia, Forssa Hospital, Forssa, Finland. helena.kallio@fstky.fi
authors.forename: H
authors.initials: H
authors.lastname: Kallio
authors.forename: E-V T
authors.initials: EV
authors.lastname: Snäll
authors.forename: C A
authors.initials: CA
authors.lastname: Tuomas
authors.forename: P H
authors.initials: PH
authors.lastname: Rosenberg
mesh_terms: D000328:Adult; D000556:Ambulatory Surgical Procedures; D000577:Amides / Q000008:administration & dosage* / Q000737:chemistry; D000700:Analgesics / Q000008:administration & dosage; D000762:Anesthesia Recovery Period; D000768:Anesthesia, General; D000775:Anesthesia, Spinal / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage* / Q000737:chemistry; D000886:Anthropometry; D004311:Double-Blind Method; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007866:Leg / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009068:Movement / Q000187:drug effects; D011446:Prospective Studies; D000077212:Ropivacaine; D012677:Sensation / Q000187:drug effects; D013046:Specific Gravity
chemical_list: D000577:Amides; D000700:Analgesics; D000779:Anesthetics, Local; D000077212:Ropivacaine