Postoperative analgesic efficacy of peripheral levobupivacaine and ropivacaine: a prospective, randomized double-blind trial in patients after total knee arthroplasty.
BACKGROUND
Several previous trials have characterized the intra- and postoperative effects of the recently introduced local anesthetics, levobupivacaine and ropivacaine, for a variety of continuous peripheral nerve blocks.


METHODS
We compared the analgesic efficacy of levobupivacaine 0.125% versus ropivacaine 0.2% via patient-controlled femoral nerve analgesia after total knee arthroplasty. In a double-blind, randomized, prospective design, 60 patients received femoral infusion with either substance. We analyzed postoperative local anesthetic consumption, pain scores, motor block, and opioid requirements over 72 h.


RESULTS
Pain scores, motor block incidence, and opioid requirements were low and not different between the groups. Ropivacaine consumption in milligrams was 67% higher than that of levobupivacaine.


CONCLUSIONS
Both levobupivacaine 0.125% and ropivacaine 0.2% provide similar analgesia after total knee arthroplasty with the latter being less potent.
Heid
Florian
F
Department of Anesthesiology, Johannes Gutenberg-University Mainz, Langenbeckstr. 1 D-55131 Mainz, Germany. heid@uni-mainz.de
Müller
Nicole
N
Piepho
Tim
T
Bäres
Maren
M
Giesa
Markus
M
Drees
Philipp
P
Rümelin
Andreas
A
Werner
Christian
C
D000368:Aged; D000369:Aged, 80 and over; D000577:Amides / Q000008:administration & dosage*; D016058:Analgesia, Patient-Controlled; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000779:Anesthetics, Local / Q000008:administration & dosage*; D019645:Arthroplasty, Replacement, Knee; D002045:Bupivacaine / Q000008:administration & dosage / Q000031:analogs & derivatives; D004311:Double-Blind Method; D005260:Female; D005267:Femoral Nerve / Q000187:drug effects*; D006801:Humans; D000077554:Levobupivacaine; D008297:Male; D008875:Middle Aged; D009407:Nerve Block; D010147:Pain Measurement; D010149:Postoperative Pain / Q000503:physiopathology / Q000517:prevention & control*; D017060:Patient Satisfaction; D011446:Prospective Studies; D000077212:Ropivacaine; D016896:Treatment Outcome; D016138:Walking
D000577:Amides; D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D000077212:Ropivacaine; D000077554:Levobupivacaine; D002045:Bupivacaine