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BRIEF REPORT

Postoperative Analgesic Efficacy of Peripheral Levobupivacaine and Ropivacaine: A Prospective, Randomized Double-Blind Trial in Patients After Total Knee Arthroplasty

Florian Heid, MD^*, Nicole Müller^*, Tim Piepho, MD^*, Maren Bäres, MD^*, Markus Giesa, MD, Philipp Drees, MD, Andreas Rümelin, MD, PhD^*, and Christian Werner, MD, PhD^*

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.