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Anesth Analg 2008; 106:301-304
© 2008 International Anesthesia Research Society
doi: 10.1213/01.ane.0000287673.27439.19
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ANALGESIA

Epinephrine 4 µg/mL Added to a Low-Dose Mixture of Ropivacaine and Fentanyl for Lumbar Epidural Analgesia After Total Knee Arthroplasty

Johannes G. Förster, MD*, Hilkka M. Lumme, MD{dagger}, Vilja J. Palkama, MD, PhD{dagger}, Per H. Rosenberg, MD, PhD*, and Mikko T. Pitkänen, MD, PhD{dagger}

From the *Department of Anaesthesiology and Intensive Care Medicine, Helsinki University Hospital, Finland; and {dagger}Department of Anesthesia, Orton Orthopedic Hospital, Invalid Foundation, Helsinki, Finland.

Address correspondence to Johannes G. Förster, MD, Department of Anaesthesiology and Intensive Care Medicine, Helsinki University Hospital, Haartmaninkatu 4, PO Box 340, 00029 Helsinki, Finland. Address e-mail to johannes.forster{at}hus.fi.

Abstract

BACKGROUND: Epinephrine 2 µg/mL added to a local anesthetic-opioid mixture has been found to improve postoperative continuous epidural analgesia at the thoracic (TEA) but not at lumbar (LEA) level. Therefore, we studied whether a higher dose of epinephrine could improve LEA.

METHODS: Patients received LEA comprising of ropivacaine 1.8 mg/mL and fentanyl 3 µg/mL either without (group RF, n = 32) or with epinephrine 4 µg/mL (group RFE, n = 31) for 2 days after total knee arthroplasty. Rescue pain medication consisted of epidural top-ups (study mixture) and parenteral oxycodone.

RESULTS: Total amounts of epidurally administered drugs were significantly higher in group RFE. Otherwise, the groups did not differ significantly regarding pain relief and side effects.

CONCLUSIONS: As part of the multimodal pain treatment used, the epidural adjuvant epinephrine 4 µg/mL (12–32 µg/h) did not improve LEA after total knee arthroplasty.






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 © 2008 by the International Anesthesia Research Society.