Comparison of 0.15% Ropivacaine/Fentanyl and 0.1% Levobupivacaine/Fentanyl Infused for Postoperative Epidural Analgesia

Abstract

Background: In this study we compared the analgesic effects and the incidences of motor weakness and other side effects of postoperative continuous epidural infusion of 0.15% ropivacaine/fentanyl or 0.1% levobupivacaine/fentanyl. Methods: Sixty seven patients scheduled for elective knee arthroplasty or revision surgery under combined spinal-epidural anesthesia were randomized to receive either 0.15% ropivacaine with 2/ml fentanyl (the ropivacaine group) or 0.1% levobupivacaine with 2/ml fentanyl (the levobupivacaine group) for postoperative epidural analgesia using a PCA pump at a rate of 5 ml/h during the 48 hour period following surgery. Verbal numerical rating scale (VNRS) scores on rest and movement, Bromage scores, additional analgesic requirements and side effects were assessed. Results: In the ropivacaine group, rest VNRS scores were lower than in the levobupivacaine group on the second postoperative day, and movement VNRS scores were also lower in the ropivacaine group during the first and second postoperative days. Bromage scores, additional analgesic requirements and side effects were similar in the two groups. Conclusions: Both 0.15% ropivacaine with 2/ml fentanyl and 0.1% levobupivacaine with 2/ml fentanyl provided effective postoperative epidural analgesia, but ropivacaine group members were able to exercise more effectively.