title: Efficacy of ropivacaine by the concentration of 0.25%, 0.5%, and 0.75% on surgical performance, postoperative analgesia, and patient's satisfaction in inguinal hernioplasty: a randomized controlled trial.
abstract: BACKGROUND
  The purpose of this study was to evaluate the use of different concentrations of ropivacaine in ultrasound-guided regional anesthesia with regard to postoperative analgesic and patient's satisfaction in elderly patients undergoing inguinal hernioplasty in the People's Republic of China.
  
  
  METHODS
  A total of 60 patients (>75 years of age) who scheduled inguinal hernioplasty at the Shenzhen People's Hospital from December 2013 to March 2015 were randomly assigned to three groups: 0.25% ropivacaine (n=20), 0.5% ropivacaine (n=20), and 0.75% ropivacaine (n=20). Ultrasound-guided regional anesthesia was performed before every surgery. Non-invasive blood pressure and heart rate were recorded before the operation, during the first 5 minutes of the surgical procedure, and 5 minutes after the operation of the patients, and compared between the groups. Incidence of adverse reactions, postoperative Visual Analog Scale score, and analgesic effect were also recorded and analyzed.
  
  
  RESULTS
  The surgical procedure and anesthesia was performed successfully in all patients. Patients with high-dose ropivacaine (0.5% and 0.75%) in ultrasound-guided regional anesthesia exhibited lower arterial pressure and lower heart rate during the operation when compared to low-dose group. The interquartile range of Visual Analog Scale scores in both group C (0.75% ropivacaine) and group B (0.5% ropivacaine) were significantly lower (P<0.05) than in group A (0.25% ropivacaine). Accordingly, the interquartile range of satisfactory scores in both group C (0.75% ropivacaine) and group B (0.5% ropivacaine) were significantly higher (P<0.05) than in group A (0.25% ropivacaine). More cases in high-dose groups reported abnormal skin sensation; however, it did not negatively affect the satisfaction level of patients.
  
  
  CONCLUSIONS
  The use of ultrasound-guided regional anesthesia with ropivacaine as an anesthetic in inguinal hernia repair for elderly patients is safe and effective, and ropivacaine is optimally effective at the concentration of 0.5% with least side effects.
authors.affiliation: Anesthesia Department, The Shenzhen People's Hospital, The Secondary Clinical Medical College of Jinan University, Shenzhen, Guangdong, People's Republic of China.
authors.forename: Yinglan
authors.initials: Y
authors.lastname: Su
authors.affiliation: Anesthesia Department, The Shenzhen People's Hospital, The Secondary Clinical Medical College of Jinan University, Shenzhen, Guangdong, People's Republic of China.
authors.forename: Zhongjun
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: Anesthesia Department, The Shenzhen People's Hospital, The Secondary Clinical Medical College of Jinan University, Shenzhen, Guangdong, People's Republic of China.
authors.forename: Yaoxian
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Anesthesia Department, The Shenzhen People's Hospital, The Secondary Clinical Medical College of Jinan University, Shenzhen, Guangdong, People's Republic of China.
authors.forename: Hanwei
authors.initials: H
authors.lastname: Li
authors.affiliation: Anesthesia Department, The Shenzhen People's Hospital, The Secondary Clinical Medical College of Jinan University, Shenzhen, Guangdong, People's Republic of China.
authors.forename: Wei
authors.initials: W
authors.lastname: Shi
keywords: analgesic effect; inguinal hernioplasty; ropivacaine; ultrasound guided ilioinguinal nerve block