This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (29) Citing Articles via Google Scholar Google Scholar Articles by Kampe, S. Articles by Lynch, J. Search for Related Content PubMed PubMed Citation Articles by Kampe, S. Articles by Lynch, J.

---

REGIONAL ANESTHESIA AND PAIN MANAGEMENT

Postoperative Analgesia with No Motor Block by Continuous Epidural Infusion of Ropivacaine 0.1% and Sufentanil After Total Hip Replacement

Sandra Kampe, MD^*, Christoph Weigand, MD^*, Jost Kaufmann^*, Markus Klimek, MD^*, Dietmar Pierre König, MD, and John Lynch, FFARCSI^*

Departments of *Anesthesiology and Orthopedic Surgery, University of Cologne, Cologne, Germany

Address correspondence and reprint requests to Sandra Kampe, MD, Department of Anesthesiology, University of Cologne, Joseph-Stelzmann-Straße 9, 50931 Cologne, Germany.

We assessed the analgesic efficacy of postoperative epidural ropivacaine 0.1% with and without sufentanil 1 µg/mL in this prospective, randomized, single-blinded study of 30 ASA physical status I–III patients undergoing elective total hip replacement. Lumbar epidural block using 0.75% ropivacaine was combined with either propofol sedation or general anesthesia for surgery. After surgery, the epidural infusion was commenced. Fifteen patients in each group received either an epidural infusion of 0.1% ropivacaine with 1 µg/mL sufentanil (R+S) or 0.1% ropivacaine without sufentanil (R) at a rate of 5–9 mL/h. All patients had access to IV piritramide via a patient-controlled analgesia device. The R+S group consumed six times less piritramide over a 48-h infusion period than the R group (median 12.7 vs 73.0 mg; P < 0.001). Motor block was negligible for the study duration in both groups. Patient satisfaction was excellent. The incidence of adverse events, such as nausea, was similar. We conclude that a continuous epidural infusion of 0.1% ropivacaine with 1 µg/mL sufentanil is more effective than ropivacaine alone in treating pain after elective hip replacement without motor block.

Implications: This is the first randomized study comparing the efficacy of the epidural combination of ropivacaine 0.1% and sufentanil 1 µg/mL versus plain ropivacaine 0.1% in treating pain after hip replacement. We found that ropivacaine 0.1% and sufentanil 1 µg/mL led to a sixfold reduction in opioid requirements after total hip replacement by producing a negligible motor block.

This article has been cited by other articles:

				P. Panousis, A. R. Heller, T. Koch, and R. J. Litz Epidural Ropivacaine Concentrations for Intraoperative Analgesia During Major Upper Abdominal Surgery: A Prospective, Randomized, Double-Blinded, Placebo-Controlled Study Anesth. Analg., June 1, 2009; 108(6): 1971 - 1976. [Abstract] [Full Text] [PDF]

				M. K. Kim, S. B. Nam, M. J. Cho, and Y.-S. Shin Epidural naloxone reduces postoperative nausea and vomiting in patients receiving epidural sufentanil for postoperative analgesia Br. J. Anaesth., August 1, 2007; 99(2): 270 - 275. [Abstract] [Full Text] [PDF]

				S. Kampe, C. Poetter, S. Buzello, H.-M. Wenchel, M. Paul, P. Kiencke, and S.-M. Kasper Ropivacaine 0.1% with Sufentanil 1 {micro}g/mL Inhibits In Vitro Growth of Pseudomonas Aeruginosa and Does Not Promote Multiplication of Staphylococcus Aureus Anesth. Analg., August 1, 2003; 97(2): 409 - 411. [Abstract] [Full Text] [PDF]

				S. Kampe, P. Kiencke, J. Krombach, K. Cranfield, S. M. Kasper, and C. Diefenbach Current Practice in Postoperative Epidural Analgesia: A German Survey Anesth. Analg., December 1, 2002; 95(6): 1767 - 1769. [Abstract] [Full Text] [PDF]

				M. Senard, J. L. Joris, D. Ledoux, P. J. Toussaint, B. Lahaye-Goffart, and M. L. Lamy A Comparison of 0.1% and 0.2% Ropivacaine and Bupivacaine Combined with Morphine for Postoperative Patient-Controlled Epidural Analgesia After Major Abdominal Surgery Anesth. Analg., August 1, 2002; 95(2): 444 - 449. [Abstract] [Full Text] [PDF]

				S. Kampe and F. Singelyn Extended Femoral Nerve Sheath Block After Total Hip Arthroplasty Response Anesth. Analg., September 1, 2001; 93(3): 804 - 804. [Full Text] [PDF]

				R. G. Wheatley, S. A. Schug, and D. Watson Safety and efficacy of postoperative epidural analgesia Br. J. Anaesth., July 1, 2001; 87(1): 47 - 61. [Abstract] [Full Text] [PDF]

				G. Brodner, N. Mertes, H. Van Aken, T. Mollhoff, M. Zahl, S. Wirtz, M. A. E. Marcus, and H. Buerkle What Concentration of Sufentanil Should be Combined with Ropivacaine 0.2% wt/vol for Postoperative Patient-Controlled Epidural Analgesia? Anesth. Analg., March 1, 2000; 90(3): 649 - 657. [Abstract] [Full Text] [PDF]