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Anesth Analg 2007;105:520-523
© 2007 International Anesthesia Research Society
doi: 10.1213/01.ane.0000267523.66285.57

ANALGESIA

Spinal Ropivacaine for Lower Limb Surgery: A Dose–Response Study

Ying Y. Lee, FFARCSI, MScPainM*{dagger}, Warwick D. Ngan Kee, MD*, Hang K. Chang, MBBS{dagger}, Chi L. So, MBBS{dagger}, and Tony Gin, MD*

From the *Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China; {dagger}Department of Anaesthesiology and Operating Theatre Services, Kwong Wah Hospital, Kowloon, Hong Kong SAR, China.

Address correspondence and reprint requests to Ying Yin Lee, Department of Anaesthesiology, Kwong Wah Hospital, 25, Waterloo Road, Kowloon, Hong Kong. Address e-mail to yyleekwh{at}yahoo.com.

Abstract

BACKGROUND: The dose–response relationship for spinal ropivacaine in patients undergoing surgery of the lower extremity has not been fully determined.

METHODS: We performed a prospective, randomized, double-blind study of 60 patients scheduled for lower limb surgery under combined spinal–epidural anesthesia. Patients were assigned to receive 1 of 5 doses of intrathecal ropivacaine: 2, 4, 7, 10, or 14 mg diluted to 2.8 mL with normal saline. A dose was considered successful if a sensory block to cold was achieved bilaterally at the T12 dermatome within 20 min and surgery proceeded without supplementation for at least 50 min.

RESULTS: Anesthesia was successful in 0, 0, 42, 83, and 100% of the 2, 4, 7, 10, and 14 mg groups, respectively. The derived value for ED50 was 7.6 mg (95% CI: 6.2–8.7 mg) and for ED95 was 11.4 mg (95% CI: 9.7–18.3 mg). The cephalic level of sensory block and the degree of motor block increased with larger doses of ropivacaine.

CONCLUSION: The ED50 and ED95 for spinal ropivacaine in lower limb surgery of 50 min duration or less were 7.6 and 11.4 mg, respectively. This provides a useful guide for clinicians to choose the optimal dose of spinal ropivacaine under different clinical situations.






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.