title: A comparison of three different concentrations of ropivacaine with fentanyl for patient-controlled epidural analgesia.
abstract: BACKGROUND
  The optimal concentration of ropivacaine in combination with fentanyl for patient-controlled epidural analgesia focusing on preservation of bowel function, analgesia, and motor function remains unclear.
  
  
  METHODS
  Three hundred-twelve women scheduled to undergo gynecologic lower abdominal surgery, were randomly allocated to receive ropivacaine 0.05, 0.075, or 0.1% in combination with fentanyl 4 mug/mL and droperidol 25 microg/mL. The settings of patient-controlled epidural analgesia were as follows: initial loading volume 5 mL, background infusion 2 mL/h during night-time, no background infusion during daytime, bolus volume 2 mL, and lockout interval 10 min. Bowel function was evaluated by the first passage of flatus and feces. Pain was assessed with a visual analog scale, and motor function was examined by modified Bromage scale. Data were collected in the evening on the day of surgery, in the morning and in the evening on the first postoperative day, and in the morning on the second postoperative day.
  
  
  RESULTS
  Gastrointestinal motility was not different among the three groups. All three solutions produced equivalent analgesia and no motor blockade.
  
  
  CONCLUSIONS
  We conclude that ropivacaine 0.05% is sufficient to preserve gastrointestinal motility, and provides excellent postoperative pain relief without motor blockade.
authors.affiliation: Department of Anesthesiology, Faculty of Medicine, University of Yamanashi, Shimokato, Chuo, Yamanashi, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Iijima
authors.forename: Tadahiko
authors.initials: T
authors.lastname: Ishiyama
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kashimoto
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Yamaguchi
authors.forename: Tomio
authors.initials: T
authors.lastname: Andoh
authors.forename: Kazumi
authors.initials: K
authors.lastname: Hanawa
authors.forename: Izumi
authors.initials: I
authors.lastname: Tanzawa
authors.forename: Keisi
authors.initials: K
authors.lastname: Kawata
authors.forename: Takehisa
authors.initials: T
authors.lastname: Hanawa
authors.forename: Yoshimitsu
authors.initials: Y
authors.lastname: Hiejima
mesh_terms: D000328:Adult; D000577:Amides / Q000008:administration & dosage*; D015360:Analgesia, Epidural / Q000379:methods*; D016058:Analgesia, Patient-Controlled / Q000379:methods*; D002626:Chemistry, Pharmaceutical; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage*; D006801:Humans; D008875:Middle Aged; D010149:Postoperative Pain / Q000453:epidemiology / Q000517:prevention & control; D000077212:Ropivacaine
chemical_list: D000577:Amides; D000077212:Ropivacaine; D005283:Fentanyl