Ropivacaine and levobupivacaine for bilateral selective ankle block in patients undergoing hallux valgus repair.
BACKGROUND
A selective ankle block, blocking the tibial, deep and superficial peroneal nerves, can be used successfully for great toe surgery. No comparative information is available on selective ankle block using ropivacaine and levobupivacaine.


METHODS
We compared the onset time and success rate of a selective ankle block using low volumes (12 ml) of ropivacaine 10 mg/ml and levobupivacaine 7.5 mg/ml in 40 patients undergoing elective repair of bilateral hallux valgus. Each patient received an ankle block induced in one foot with ropivacaine and in the contralateral foot with levobupivacaine.


RESULTS
The success rate was higher [90% vs. 75%, hazard ratio (95% CI) 0.39 (0.23-0.64)] and anesthesia onset time was shorter (median, 10 vs. 20 min) after ropivacaine than after levobupivacaine. In successful ankle blocks, post-operative pain was similar in the two groups.


CONCLUSIONS
In this study, ropivacaine 10 mg/ml had a shorter anesthesia onset time and a higher success rate than levobupivacaine 7.5 mg/ml for selective ankle block.
Palmisani
S
S
Department of Anesthesiology and Intensive Care Medicine, Second Faculty of Medicine, Sant'Andrea Hospital, University of Rome La Sapienza, Rome, Italy. stefano.palmisani@uniroma1.it
Arcioni
R
R
Di Benedetto
P
P
De Blasi
R A
RA
Mercieri
M
M
Ronconi
P
P
D000577:Amides / Q000008:administration & dosage* / Q000009:adverse effects; D000779:Anesthetics, Local / Q000008:administration & dosage* / Q000009:adverse effects; D002045:Bupivacaine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives; D004311:Double-Blind Method; D017558:Elective Surgical Procedures / Q000379:methods; D005260:Female; D006215:Hallux Valgus / Q000601:surgery*; D006801:Humans; D000077554:Levobupivacaine; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D010147:Pain Measurement / Q000706:statistics & numerical data; D010149:Postoperative Pain / Q000188:drug therapy; D000077212:Ropivacaine; D018709:Statistics, Nonparametric
D000577:Amides; D000779:Anesthetics, Local; D000077212:Ropivacaine; D000077554:Levobupivacaine; D002045:Bupivacaine