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From the Departments of *Anesthesiology, and
Orthopaedic Surgery, Johannes Gutenberg-University Mainz, Germany.
Address correspondence and reprint requests to Florian Heid, MD, Department of Anesthesiology, Johannes Gutenberg-University Mainz, Langenbeckstr. 1 D-55131 Mainz, Germany. Address e-mail to heid{at}uni-mainz.de.
Abstract
BACKGROUND: Several previous trials have characterized the intra- and postoperative effects of the recently introduced local anesthetics, levobupivacaine and ropivacaine, for a variety of continuous peripheral nerve blocks.
METHODS: We compared the analgesic efficacy of levobupivacaine 0.125% versus ropivacaine 0.2% via patient-controlled femoral nerve analgesia after total knee arthroplasty. In a double-blind, randomized, prospective design, 60 patients received femoral infusion with either substance. We analyzed postoperative local anesthetic consumption, pain scores, motor block, and opioid requirements over 72 h.
RESULTS: Pain scores, motor block incidence, and opioid requirements were low and not different between the groups. Ropivacaine consumption in milligrams was 67% higher than that of levobupivacaine.
CONCLUSIONS: Both levobupivacaine 0.125% and ropivacaine 0.2% provide similar analgesia after total knee arthroplasty with the latter being less potent.
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