title: The effects of an epidural infusion of ropivacaine versus saline on sensory block after spinal anesthesia.
abstract: OBJECTIVE
  Several investigators have described the effect of bolus injections on sensory block during combined spinal epidural anesthesia. This study investigates the effects of the immediate epidural infusion of 0.2% ropivacaine versus 0.9% saline on spinal anesthesia.
  
  
  METHODS
  Forty-four patients undergoing partial hip replacement were randomly assigned to 2 groups, receiving epidural infusion of 0.2% ropivacaine 10 mL/h (group R, n = 22) or 0.9% NaCl 10 mL/h (group S, n = 22), immediately after spinal anesthesia with 7.5 mg 0.5% hyperbaric bupivacaine. Postoperative analgesia was provided in both groups using a ropivacaine patient-controlled epidural analgesia technique. Sensory block, motor block, postoperative pain scores, ropivacaine consumption, and patient satisfaction were recorded.
  
  
  RESULTS
  There was no difference between the 2 groups in the characteristics of the sensory block. The duration of motor block was prolonged in group R (312 +/- 95 minutes vs 198 +/- 78 minutes; P < .001). Postoperative pain scores and 24-hour ropivacaine consumption were similar among groups. Demand/delivery ratio was 1.6 in group R and 3.5 in group S (P = .048). A significantly higher number of patients in group R described their satisfaction as excellent (20 patients vs 6 patients; P < .001).
  
  
  CONCLUSIONS
  Epidural infusion of ropivacaine 0.2% initiated immediately after spinal anesthesia prolonged the regression of motor block but not the regression of sensory block when compared with saline infusion.
authors.affiliation: Department of Anesthesiology and Reanimation, Izmir Ataturk Training Research Hospital, Basinsitesi, Izmir, Turkey.
authors.forename: Dogan
authors.initials: D
authors.lastname: Guryay
authors.forename: Gunes Terzi
authors.initials: GT
authors.lastname: Karaege
authors.forename: Kaan
authors.initials: K
authors.lastname: Katircioglu
authors.forename: Murat Yasar
authors.initials: MY
authors.lastname: Ozkalkanli
authors.forename: Ugur
authors.initials: U
authors.lastname: Ozgurbuz
authors.forename: Serdar
authors.initials: S
authors.lastname: Savaci
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000577:Amides / Q000008:administration & dosage*; D016058:Analgesia, Patient-Controlled; D000767:Anesthesia, Epidural; D000775:Anesthesia, Spinal; D000779:Anesthetics, Local / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009475:Neurons, Afferent / Q000187:drug effects* / Q000502:physiology; D010147:Pain Measurement / Q000706:statistics & numerical data; D017060:Patient Satisfaction; D011446:Prospective Studies; D000077212:Ropivacaine; D012965:Sodium Chloride; D018709:Statistics, Nonparametric; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000577:Amides; D000779:Anesthetics, Local; D012965:Sodium Chloride; D000077212:Ropivacaine