title: Comparison of ropivacaine 0.2% and 0.25% with lidocaine 0.5% for intravenous regional anesthesia.
abstract: OBJECTIVE
  To compare the anesthetic effects of two different concentrations and doses of ropivacaine (0.2% and 0.25%) with those of a conventional dose of lidocaine 0.5%.
  
  
  METHODS
  Prospective, randomized, double-blinded, clinical investigation.
  
  
  METHODS
  Large metropolitan university hospital.
  
  
  METHODS
  66 adult ASA physical status I and II patients undergoing forearm and hand surgery.
  
  
  METHODS
  Patients were randomly allocated to three groups to receive intravenous regional anesthesia (IVRA). Study groups were: ropivacaine 0.2% (Group I, n = 22), ropivacaine 0.25% (Group II, n = 22), and lidocaine 0.5% (Group III, n = 22).
  
  
  METHODS
  Tourniquet tolerance times and regression of sensory analgesia were noted. Verbal numerical pain scores (VNS), cumulative analgesic consumption, and side effects were recorded during surgery and postanesthesia care unit (PACU). Time to first pain medication intake and number of patients receiving analgesics in the PACU were recorded.
  
  
  RESULTS
  Additional tolerance times for the distal tourniquet were significantly higher in the ropivacaine 0.25% group than the other two groups. Regression of sensory anesthesia was fastest in the lidocaine group. During the PACU stay, VNSs were significantly lower in the first 20 minutes in the ropivacaine groups than the lidocaine group. Time to first intake of pain medication in the PACU was soonest in the lidocaine group. The number of patients given analgesics in the PACU was highest in the lidocaine group. The number of patients taking > two tablets of tramadol was significantly lowest in the ropivacaine 0.25% group. No serious side effects were observed in any study group.
  
  
  CONCLUSIONS
  Longer tolerance times for the distal tourniquet, prolonged analgesia after tourniquet release, and lower analgesic requirements postoperatively make ropivacaine 0.2% and 0.25% an alternative to lidocaine for IVRA.
authors.affiliation: Department of Anesthesiology and Reanimation, Ankara University Medical School, Ankara, Turkey.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Asik
authors.forename: Aysu Inan
authors.initials: AI
authors.lastname: Kocum
authors.forename: Asutay
authors.initials: A
authors.lastname: Goktug
authors.forename: K Sanem Cakar
authors.initials: KS
authors.lastname: Turhan
authors.forename: Neslihan
authors.initials: N
authors.lastname: Alkis
mesh_terms: D000328:Adult; D000577:Amides / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000700:Analgesics / Q000627:therapeutic use; D000765:Anesthesia, Conduction / Q000009:adverse effects / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D005542:Forearm / Q000601:surgery; D006225:Hand / Q000601:surgery; D006785:Hospitals, University; D006801:Humans; D008012:Lidocaine / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy; D011446:Prospective Studies; D000077212:Ropivacaine; D013997:Time Factors; D014111:Tourniquets
chemical_list: D000577:Amides; D000700:Analgesics; D000779:Anesthetics, Local; D000077212:Ropivacaine; D008012:Lidocaine