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Spinal hyperbaric ropivacaine-fentanyl for day-surgery

Adequate intraoperative analgesia combined with faster mobilization might be achieved by replacing hyperbaric ropivacaine partly with fentanyl. Sixty spinal anesthesia patients were randomized into 2 groups of either fentanyl 20 μg mixed with hyperbaric ropivacaine 10 mg (group FR10) or hyperbaric r... Full description

Journal Title: Regional anesthesia and pain medicine 2005, Vol.30 (1), p.48-54
Main Author: Kallio, Helena
Other Authors: Snäll, Eljas-Veli T , Suvanto, Sami J , Tuomas, Carl A , Iivonen, Mauri K , Pokki, Juha-Pekka , Rosenberg, Per H
Format: Electronic Article Electronic Article
Language: English
Subjects:
Quelle: Alma/SFX Local Collection
Publisher: England: Elsevier Inc
ID: ISSN: 1098-7339
Link: https://www.ncbi.nlm.nih.gov/pubmed/15690268
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recordid: cdi_proquest_miscellaneous_67400674
title: Spinal hyperbaric ropivacaine-fentanyl for day-surgery
format: Article
creator:
  • Kallio, Helena
  • Snäll, Eljas-Veli T
  • Suvanto, Sami J
  • Tuomas, Carl A
  • Iivonen, Mauri K
  • Pokki, Juha-Pekka
  • Rosenberg, Per H
subjects:
  • Adult
  • Aged
  • Ambulatory Surgical Procedures - methods
  • Amides - administration & dosage
  • Anesthesia, Spinal - methods
  • Anesthetic techniques
  • Anesthetics, Combined - administration & dosage
  • Female
  • Fentanyl
  • Fentanyl - administration & dosage
  • Humans
  • Hyperbaric anesthetic local
  • Male
  • Middle Aged
  • Nerve Block - methods
  • Ropivacaine
  • Subarachnoid
ispartof: Regional anesthesia and pain medicine, 2005, Vol.30 (1), p.48-54
description: Adequate intraoperative analgesia combined with faster mobilization might be achieved by replacing hyperbaric ropivacaine partly with fentanyl. Sixty spinal anesthesia patients were randomized into 2 groups of either fentanyl 20 μg mixed with hyperbaric ropivacaine 10 mg (group FR10) or hyperbaric ropivacaine 15 mg (group R15). Forty-five patients underwent inguinal hernia repair and 15 patients had lower extremity surgery. Sensory block was tested by pinprick, and motor block was tested by use of a modified Bromage scale at 5-minute intervals for 30 minutes, 15-minute intervals for 60 minutes, and at 30-minute intervals until full recovery. The groups did not differ significantly regarding success (27 of 30 [group FR10] and 29 of 30 [group R15]), median onset time (10 [5 to 25] v 10 [5 to 20] minutes) or median duration of T10 sensory block (55 [20 to 115] v 80 [5 to 170] minutes), respectively. Recovery from spinal block was significantly quicker in group FR10 than in group R15, recorded in ability to walk (2.5 hours v 3 hours [ P = .017]), full motor recovery (1 hour v 1.5 hour [ P < .001]), and sensory recovery to S1 (2.5 hours v 3.3 hours [ P = .026]). Pruritus occurred in 18 (60%) of group FR10 v 0 of group R15 patients ( P < .001). This symptom was mild in all except 1 patient, who received ondansetron 8 mg IV. In the OR, the groups did not differ hemodynamically: 9 (30%) of the group FR10 and 10 (33%) of the group R15 patients, respectively, required medication for hypotension and/or bradycardia. Full motor block (Bromage 3) developed less frequently ( P < .001) in group FR10 patients than in group R15 patients (1 [3%] v 14 [47%]), and the group FR10 patients recovered faster in a median time of 60 v 90 minutes ( P < .001). In both groups, sensory and motor blocks were more extensive on the operative side compared with the nonoperative side ( P < .001). Faster mobilization but equal onset and duration of analgesia were achieved with intrathecal hyperbaric ropivacaine 10 mg plus fentanyl 20 μg as compared with hyperbaric ropivacaine 15 mg.
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 1098-7339
fulltext: fulltext
issn:
  • 1098-7339
  • 1532-8651
url: Link


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creatorKallio, Helena ; Snäll, Eljas-Veli T ; Suvanto, Sami J ; Tuomas, Carl A ; Iivonen, Mauri K ; Pokki, Juha-Pekka ; Rosenberg, Per H
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descriptionAdequate intraoperative analgesia combined with faster mobilization might be achieved by replacing hyperbaric ropivacaine partly with fentanyl. Sixty spinal anesthesia patients were randomized into 2 groups of either fentanyl 20 μg mixed with hyperbaric ropivacaine 10 mg (group FR10) or hyperbaric ropivacaine 15 mg (group R15). Forty-five patients underwent inguinal hernia repair and 15 patients had lower extremity surgery. Sensory block was tested by pinprick, and motor block was tested by use of a modified Bromage scale at 5-minute intervals for 30 minutes, 15-minute intervals for 60 minutes, and at 30-minute intervals until full recovery. The groups did not differ significantly regarding success (27 of 30 [group FR10] and 29 of 30 [group R15]), median onset time (10 [5 to 25] v 10 [5 to 20] minutes) or median duration of T10 sensory block (55 [20 to 115] v 80 [5 to 170] minutes), respectively. Recovery from spinal block was significantly quicker in group FR10 than in group R15, recorded in ability to walk (2.5 hours v 3 hours [ P = .017]), full motor recovery (1 hour v 1.5 hour [ P < .001]), and sensory recovery to S1 (2.5 hours v 3.3 hours [ P = .026]). Pruritus occurred in 18 (60%) of group FR10 v 0 of group R15 patients ( P < .001). This symptom was mild in all except 1 patient, who received ondansetron 8 mg IV. In the OR, the groups did not differ hemodynamically: 9 (30%) of the group FR10 and 10 (33%) of the group R15 patients, respectively, required medication for hypotension and/or bradycardia. Full motor block (Bromage 3) developed less frequently ( P < .001) in group FR10 patients than in group R15 patients (1 [3%] v 14 [47%]), and the group FR10 patients recovered faster in a median time of 60 v 90 minutes ( P < .001). In both groups, sensory and motor blocks were more extensive on the operative side compared with the nonoperative side ( P < .001). Faster mobilization but equal onset and duration of analgesia were achieved with intrathecal hyperbaric ropivacaine 10 mg plus fentanyl 20 μg as compared with hyperbaric ropivacaine 15 mg.
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subjectAdult ; Aged ; Ambulatory Surgical Procedures - methods ; Amides - administration & dosage ; Anesthesia, Spinal - methods ; Anesthetic techniques ; Anesthetics, Combined - administration & dosage ; Female ; Fentanyl ; Fentanyl - administration & dosage ; Humans ; Hyperbaric anesthetic local ; Male ; Middle Aged ; Nerve Block - methods ; Ropivacaine ; Subarachnoid
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descriptionAdequate intraoperative analgesia combined with faster mobilization might be achieved by replacing hyperbaric ropivacaine partly with fentanyl. Sixty spinal anesthesia patients were randomized into 2 groups of either fentanyl 20 μg mixed with hyperbaric ropivacaine 10 mg (group FR10) or hyperbaric ropivacaine 15 mg (group R15). Forty-five patients underwent inguinal hernia repair and 15 patients had lower extremity surgery. Sensory block was tested by pinprick, and motor block was tested by use of a modified Bromage scale at 5-minute intervals for 30 minutes, 15-minute intervals for 60 minutes, and at 30-minute intervals until full recovery. The groups did not differ significantly regarding success (27 of 30 [group FR10] and 29 of 30 [group R15]), median onset time (10 [5 to 25] v 10 [5 to 20] minutes) or median duration of T10 sensory block (55 [20 to 115] v 80 [5 to 170] minutes), respectively. Recovery from spinal block was significantly quicker in group FR10 than in group R15, recorded in ability to walk (2.5 hours v 3 hours [ P = .017]), full motor recovery (1 hour v 1.5 hour [ P < .001]), and sensory recovery to S1 (2.5 hours v 3.3 hours [ P = .026]). Pruritus occurred in 18 (60%) of group FR10 v 0 of group R15 patients ( P < .001). This symptom was mild in all except 1 patient, who received ondansetron 8 mg IV. In the OR, the groups did not differ hemodynamically: 9 (30%) of the group FR10 and 10 (33%) of the group R15 patients, respectively, required medication for hypotension and/or bradycardia. Full motor block (Bromage 3) developed less frequently ( P < .001) in group FR10 patients than in group R15 patients (1 [3%] v 14 [47%]), and the group FR10 patients recovered faster in a median time of 60 v 90 minutes ( P < .001). In both groups, sensory and motor blocks were more extensive on the operative side compared with the nonoperative side ( P < .001). Faster mobilization but equal onset and duration of analgesia were achieved with intrathecal hyperbaric ropivacaine 10 mg plus fentanyl 20 μg as compared with hyperbaric ropivacaine 15 mg.
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abstractAdequate intraoperative analgesia combined with faster mobilization might be achieved by replacing hyperbaric ropivacaine partly with fentanyl. Sixty spinal anesthesia patients were randomized into 2 groups of either fentanyl 20 μg mixed with hyperbaric ropivacaine 10 mg (group FR10) or hyperbaric ropivacaine 15 mg (group R15). Forty-five patients underwent inguinal hernia repair and 15 patients had lower extremity surgery. Sensory block was tested by pinprick, and motor block was tested by use of a modified Bromage scale at 5-minute intervals for 30 minutes, 15-minute intervals for 60 minutes, and at 30-minute intervals until full recovery. The groups did not differ significantly regarding success (27 of 30 [group FR10] and 29 of 30 [group R15]), median onset time (10 [5 to 25] v 10 [5 to 20] minutes) or median duration of T10 sensory block (55 [20 to 115] v 80 [5 to 170] minutes), respectively. Recovery from spinal block was significantly quicker in group FR10 than in group R15, recorded in ability to walk (2.5 hours v 3 hours [ P = .017]), full motor recovery (1 hour v 1.5 hour [ P < .001]), and sensory recovery to S1 (2.5 hours v 3.3 hours [ P = .026]). Pruritus occurred in 18 (60%) of group FR10 v 0 of group R15 patients ( P < .001). This symptom was mild in all except 1 patient, who received ondansetron 8 mg IV. In the OR, the groups did not differ hemodynamically: 9 (30%) of the group FR10 and 10 (33%) of the group R15 patients, respectively, required medication for hypotension and/or bradycardia. Full motor block (Bromage 3) developed less frequently ( P < .001) in group FR10 patients than in group R15 patients (1 [3%] v 14 [47%]), and the group FR10 patients recovered faster in a median time of 60 v 90 minutes ( P < .001). In both groups, sensory and motor blocks were more extensive on the operative side compared with the nonoperative side ( P < .001). Faster mobilization but equal onset and duration of analgesia were achieved with intrathecal hyperbaric ropivacaine 10 mg plus fentanyl 20 μg as compared with hyperbaric ropivacaine 15 mg.
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pmid15690268
doi10.1016/j.rapm.2004.11.002