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Anesth Analg 2007;105:507-511
© 2007 International Anesthesia Research Society
doi: 10.1213/01.ane.0000269491.04233.3b

ANALGESIA

A Comparison of Three Different Concentrations of Ropivacaine with Fentanyl for Patient-Controlled Epidural Analgesia

Tetsuya Iijima, MD*, Tadahiko Ishiyama, MD, PhD*, Satoshi Kashimoto, MD, PhD*, Toshiaki Yamaguchi, MD, PhD*, Tomio Andoh, MD, PhD*, Kazumi Hanawa, MSc{dagger}, Izumi Tanzawa, BSc{dagger}, Keisi Kawata, BSc{dagger}, Takehisa Hanawa, PhD{dagger}, and Yoshimitsu Hiejima, PhD{ddagger}

From the *Department of Anesthesiology, Faculty of Medicine, University of Yamanashi; {dagger}Department of Pharmacy, University of Yamanashi Hospital, Yamanashi, Japan; and {ddagger}School of Nursing, Faculty of Healthcare, Tokyo Healthcare University, Tokyo, Japan.

Address correspondence and reprint requests to Tadahiko Ishiyama, MD, PhD, Department of Anesthesiology, Faculty of Medicine, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi 409-3898, Japan. Address e-mail to ishiyama{at}yamanashi.ac.jp.

Abstract

BACKGROUND: The optimal concentration of ropivacaine in combination with fentanyl for patient-controlled epidural analgesia focusing on preservation of bowel function, analgesia, and motor function remains unclear.

METHODS: Three hundred-twelve women scheduled to undergo gynecologic lower abdominal surgery, were randomly allocated to receive ropivacaine 0.05, 0.075, or 0.1% in combination with fentanyl 4 µg/mL and droperidol 25 µg/mL. The settings of patient-controlled epidural analgesia were as follows: initial loading volume 5 mL, background infusion 2 mL/h during night-time, no background infusion during daytime, bolus volume 2 mL, and lockout interval 10 min. Bowel function was evaluated by the first passage of flatus and feces. Pain was assessed with a visual analog scale, and motor function was examined by modified Bromage scale. Data were collected in the evening on the day of surgery, in the morning and in the evening on the first postoperative day, and in the morning on the second postoperative day.

RESULTS: Gastrointestinal motility was not different among the three groups. All three solutions produced equivalent analgesia and no motor blockade.

CONCLUSION: We conclude that ropivacaine 0.05% is sufficient to preserve gastrointestinal motility, and provides excellent postoperative pain relief without motor blockade.






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2007 by the International Anesthesia Research Society.