Prospective randomized, blind comparison of ropivacaine and levobupivacaine for superficial plexus anesthesia in carotid endoarterectomy.
BACKGROUND
The authors performed a study to evaluate if the onset time, duration of sensory block, and quality of postoperative analgesia in superficial cervical plexus anesthesia with 0.5% levobupivacaine (1 mg/kg) was greater than 0.75% ropivacaine (1.5 mg/kg).


METHODS



METHODS
randomized, double-blind study.


METHODS
University teaching hospital.


METHODS
28 consecutive patients undergoing elective carotid thromboendoarterectomy were randomized into two groups.


METHODS
patients received either 1 mg/kg of 0.5% levobupivacaine (N.=15), or 1.5 mg/kg of 0.75% ropivacaine (N.=13). We assessed the onset time (pinprick test), duration of sensory block, and postoperative analgesia with the two drugs.


RESULTS
Onset time of sensory block was 20+/-6 min with ropivacaine and 29+/-8 min with levobupivacaine (P=0.003). Intraoperatively we used different total doses of lidocaine, with the median (interquartile range) dose of 50 (40-100) mg for ropivacaine and 130 (60-180) mg for levobupivacaine (P=0.05). The first pain medication was requested after 12+/-0.4 h by ropivacaine patients and after 11+/-1.6 h by levobupivacaine patients (P=0.5).


CONCLUSIONS
No beneficial effect was noted in the quality of nerve block or patient's satisfaction for 0.5% levobupivacaine when compared to 0.75% ropivacaine.
Messina
M
M
Department of Cardiothoracic and Vascular Anesthesia, San Raffaele Vita-Salute University, Milan, Italy.
Magrin
S
S
Bignami
E
E
Maj
G
G
Carozzo
A
A
Mennella
R
R
Landoni
G
G
Zangrillo
A
A
D000368:Aged; D000577:Amides; D000779:Anesthetics, Local; D002045:Bupivacaine / Q000031:analogs & derivatives; D002572:Cervical Plexus; D004311:Double-Blind Method; D016894:Endarterectomy, Carotid; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D000077554:Levobupivacaine; D008297:Male; D008875:Middle Aged; D009407:Nerve Block; D000077212:Ropivacaine
D000577:Amides; D000779:Anesthetics, Local; D000077212:Ropivacaine; D000077554:Levobupivacaine; D002045:Bupivacaine