The relative potencies for motor block after intrathecal ropivacaine, levobupivacaine, and bupivacaine.
Anesth Analg
; 104(4): 904-7, 2007 Apr.
Article
em En
| MEDLINE
| ID: mdl-17377104
ABSTRACT
BACKGROUND:
In this study, we sought to determine the median effective dose (ED50) for motor block of intrathecal ropivacaine, levobupivacaine, and bupivacaine and to define their motor-blocking potency ratios.METHODS:
We enrolled 104 parturients undergoing elective cesarean delivery with combined spinal-epidural anesthesia and randomized them to one of three groups to receive intrathecal 0.5% (wt/vol) ropivacaine, levobupivacaine, or bupivacaine. The initial dose was 4 mg, and the testing interval was set at 1 mg. Efficacy was determined by the occurrence of any motor block in either lower limb (modified Bromage and hip motor function scale) within 5 min after the spinal injection.RESULTS:
As assessed using up-down analysis, intrathecal ED50 for motor block was 5.79 mg for ropivacaine (95% CI 4.62-6.96), 4.83 mg for levobupivacaine (95% CI 4.35-5.32) and 3.44 mg for bupivacaine (95% CI 2.55-4.34) (P < 0.0007). The relative motor blocking potency ratios were ropivacaine/bupivacaine 0.59 (95% CI, 0.42-0.82), ropivacaine/levobupivacaine 0.83 (95% CI 0.64-1.09), and levobupivacaine/bupivacaine 0.71 (95% CI 0.51-0.98).CONCLUSIONS:
There is a clinical profile of potency for motor block for the pipecolylxylidines when administered spinally low, intermediate, and high for ropivacaine, levobupivacaine, and bupivacaine, respectively.
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Base de dados:
MEDLINE
Assunto principal:
Bupivacaína
/
Cesárea
/
Amidas
/
Anestésicos Locais
/
Atividade Motora
/
Bloqueio Nervoso
Tipo de estudo:
Clinical_trials
/
Observational_studies
Limite:
Adult
/
Female
/
Humans
Idioma:
En
Revista:
Anesth Analg
Ano de publicação:
2007
Tipo de documento:
Article
País de afiliação:
Itália