Analgesic Effect Of Ropivacaine Research Articles

To compare the efficacy of ropivacaine alone versus ropivacaine with magnesium sulphate for postoperative analgesia in peripheral nerve stimulator-guided supraclavicular plexus block in upper limb surgeries

Background Postoperative pain management is a crucial part of patient care for surgeries involving the upper limbs. A popular technique for providing both postoperative analgesia and regional anaesthesia is a supraclavicular plexus block guided by a peripheral nerve stimulator. Recent research has demonstrated that the analgesic effect of ropivacaine, a common local anaesthetic, can be enhanced by the addition of magnesium sulphate. The study aims to assess the safety and effectiveness of utilising magnesium sulphate in addition to ropivacaine alone for postoperative analgesia in patients having upper limb surgeries under peripheral nerve stimulator-guided supraclavicular plexus block. Methods This protocol outlines a prospective, double-blind, randomised, controlled trial that assesses the efficacy of ropivacaine versus ropivacaine plus magnesium sulphate for analgesia post surgery in patients undergoing upper limb surgeries under the guidance of a peripheral nerve stimulator (PNS). 50 Patients will be included in the study in total, and they will be split into two groups at random. PNS-guided supraclavicular plexus block with ropivacaine alone will be administered to one group, while ropivacaine combined with magnesium sulphate will be administered to the other. Regular monitoring will be done during the postoperative phase to determine pain levels, use of analgesics, motor and sensory blockade, and adverse events. Results The study aims to determine if ropivacaine with magnesium sulphate postoperative analgesia is superior to ropivacaine alone in supraclavicular plexus blocks. The motor and sensory blockade duration, opioid use, and any negative results will be evaluated as secondary outcomes. Statistical analysis will be performed to determine the significance of the differences between the two groups. Conclusion This study protocol compares the effectiveness of ropivacaine alone against ropivacaine with magnesium sulphate in peripheral nerve stimulator-guided supraclavicular plexus block, with the goal of adding to the repository of information on postoperative analgesia in upper limb procedures. The study’s findings could be very helpful in enhancing pain management strategies and enhancing patient outcomes in this context.

Analgesic effect of ropivacaine with fentanyl in comparison with ropivacaine alone for continuous femoral nerve block after knee replacement arthroplasty: a prospective, randomized, double-blinded study.

BackgroundThe analgesic effect of perineural opioid in clinical practice are still controversial. This randomized controlled trial compared analgesic effect of ropivacaine with fentanyl or ropivacaine alone for continuous femoral nerve block following unilateral total knee arthroplasty.MethodsFourty patients of ASA PS Ⅰ or Ⅱ receiving total knee arthroplasty with spinal anesthesia were enlisted and randomly allocated into two groups. Group R; bolus injection of 0.375% ropivacaine, 30 ml and an infusion of 0.2% ropivacaine at 8 ml/h (n = 20). Group RF; 0.375% ropivacaine, 29 ml added with 50 μg of fentanyl as a bolus and an infusion of 0.2% ropivacaine mixed with 1 μg/ml of fentanyl at 8 ml/h (n = 20). Local anesthetic infusion via a femoral nerve catheter was started at the end of operation and continued for 48 h. Intravenous patient-controlled analgesia with hydromorphone (0.15 mg/ml, 0-1-10) were used for adjuvant analgesics. Position of catheter tip and contrast distribution, visual analogue scale of pain, hydromorphone consumption, side effects were recorded for 48 h after operation. Patient satisfaction for the pain control received were noted.ResultsThe pain visual analogue scale, incidences of side effects and satisfaction were not different between the two groups (P > 0.05), but the hydromorphone usage at 48 h after operation were lower in the Group RF than in the Group R (P = 0.047).ConclusionsThe analgesic effect of ropivacaine with fentanyl for continuous femoral nerve block after knee replacement arthroplasty was not superior to that of the ropivacaine alone.

Comparison of the Analgesic Effect of Ropivacaine with Fentanyl and Ropivacaine Alone in Continuous Epidural Infusion for Acute Herpes Zoster Management: A Retrospective Study.

Background and Objectives: Currently, few studies have reported the effects of opioids during continuous epidural infusion (CEI) to control pain owing to herpes zoster (HZ). This study aimed to retrospectively compare the effectiveness of epidural opioids in the treatment of acute HZ pain. Materials and Methods: We reviewed medical records of 105 patients who were divided into two groups: R group (CEI with ropivacaine) and RF group (CEI with ropivacaine and fentanyl). Clinical efficacy was evaluated using the numeric rating scale (NRS) score for 6 months after the procedures. We compared the percentage of patients with complete remission in each group. We investigated the complication rates during CEI. Results: No significant differences in the NRS scores were observed between the two groups in the 6-month period. The adjusted odds ratio (OR) for patients included in the complete remission was 0.6 times lower in the RF group than in the R group (95% confidence interval: 0.22–1.71, p = 0.35). The OR for complications during CEI was higher in the RF group than in the R group. However, the difference was not statistically significant. Conclusions: No difference was observed in the management of HZ pain and the prevention of postherpetic neuralgia between the two groups. The incidence of complications tended to be higher in the RF group than in the R group.

Long-term effect of ropivacaine nanoparticles for sciatic nerve block on postoperative pain in rats

PurposeThe analgesic effect of ropivacaine (Rop) for nerve block lasts only ~3–6 hours for single use. The aim of this study was to develop long-acting regional anesthetic Rop nanoparticles and investigate the effects of sciatic nerve block on postoperative pain in rats.Materials and methodsRop nanoparticles were developed using polyethylene glycol-co-polylactic acid (PELA). One hundred and twenty adult male Wistar rats were randomly divided into four groups (n=30, each): Con (control group; 0.9% saline, 200 µL), PELA (PELA group; 10 mg), Rop (Rop group; 0.5%, 200 µL), and Rop-PELA (Rop-PELA group; 10%, 10 mg). Another 12 rats were used for the detection of Rop concentration in plasma. The mechanical withdrawal threshold and thermal withdrawal latency were measured at 2 hours, 4 hours, 8 hours, 1 day, 2 days, 3 days, 5 days, and 7 days after incision. The expression of c-FOS was determined by immunohistochemistry at 2 hours, 8 hours, 48 hours, and 7 days. Nerve and organ toxicities were also evaluated at 7 days.ResultsThe duration of Rop absorption in the plasma of the Rop-PELA group was longer (>8 hours) than that of the Rop group (4 hours). Mechanical withdrawal threshold and thermal withdrawal latency in the Rop-PELA group were higher than that in other groups (4 hours–3 days). c-FOS expression in the Rop-PELA group was lower than that in the control group at 2 hours, 8 hours, and 48 hours and lower than that in the Rop group at 8 hours and 48 hours after paw incision. Slight foreign body reactions were observed surrounding the sciatic nerve at 7 days. No obvious pathophysiological change was found in the major organs after Rop-PELA administration at 7 days.ConclusionRop-PELA provides an effective analgesia for nerve block over 3 days after single administration, and the analgesic mechanism might be mediated by the regulation of spinal c-FOS expression. However, its potential long-term tissue toxicity needs to be further investigated.

Assessment of ropivacaine postoperative analgesic effect after periapical maxillary incisors surgery

Ropivacaine is a relatively new long-acting local anesthetic. The aim of this study was to compare the postoperative analgesic effect of topical anesthetics ropivacaine 0.75% and lidocaine 2% with adrenaline in the postoperative treatment of periapical lesions in the maxilla. The study was conducted on 60 subjects, divided into two groups. The study-group received 0.75% ropivacaine without a vasoconstrictor, while the control group was treated with 2% lidocaine with adrenaline (1 : 80.000). Block anesthesia for n. infraorbitalis was used and local anesthetics were applied also on the palatine side for the end branches of n. nasopalatinus. The following parameters were observed: time elapsed from the application of an anesthetic until the first occurrence of pain after the surgery and first intake of an analgesic, the intensity of initial pain, pain intensity 6 h after the application of anesthetics and the total number of analgesics taken within 24 h after the completion of surgery. The pain appeared statistically significantly earlier in the patients who had been given lidocaine with adrenaline (p < 0.001), while statistically significantly higher mean values of initial postoperative pain (p < 0.05) and pain intensity 6 h after the intervention (p < 0.01) were also registered in the same group of patients. In the period of 24 h upon the intervention, the study-group patients were taking less analgesics as compared to the control-group subjects (46.6% vs 73.3%), who were given analgesics earlier, although no statistically significant differences were observed related to the number of analgesic doses taken. The results of our study indicate a better postoperative analgesic effect of ropivacaine as compared to lidocaine with adrenaline.

A Comparative Study on the analgesic effect of ropivacaine and lidocaine during and following episiotomy perineorrhaphy

Objective To compare the analgesic effect of ropivacaine and lidocaine during and after lateral episiotomy perineorrhaphy. Methods 80 mental well pregnant women who needed to have the lateral episiotomy perineorrhaphy were selected as our participants, they were all without surgical contraindications and obstetric complications. Then they were randomly divided into 2 groups, the experimental and the control group, and each group consisted 40 participants. Before the episiotomy, the experimental group was applied with 0.375% ropivacaine 20ml, the control group was applied with 1% lidocaine 20ml respectively to achieve perineal nerve block anesthesia and subcutaneous infiltration anesthesia. In the study we not only compared the pain level and the analgesia time between the 2 groups and also evaluated the Apgar score, the postpartum urinary retention and other adverse reactions between them. Results The VAS score of the experimental group is lower than that in the control group during and after the analgesic was administrated 1 hour, 2 hours, 4 hours and 8 hours, F=6.01( P＜0.05 ). It reminds us that not only the analgesic effect but also the analgesia time of ropivacaine is better than the lidocaine, however, the Apgar's 1 minute's and 5 minute's score were non-significant between the 2 groups, t=1.863 ( P＞ 0.05 ), and the adverse effects such as Postpartum hemorrhage and Urinary retention were also non-significant between the 2 groups .Conclusion Compared with lidocaine, ropivacaine's analgesic effect is much stronger and it's analgesic time is much longer. When we apply the lateral episiotomy perineorrhaphy, we use low-dose ropivacaine instead of lidocaine to achieve the goal of perineal subcutaneous infiltration anesthesia and nerve block anesthesia, we can relieve the Incision pain during and after the operation effectively at the same time providing a better recovery premise for the pregnant women. Key words: Ropivacaine; Lateral episiotomy perineorrhaphy; Analgesic effect

The Analgesic Properties of Scalp Infiltrations with Ropivacaine After Intracranial Tumoral Resection

The issue of postoperative pain after neurosurgery is controversial. It has been reported as mild to moderate and its treatment may be inadequate. Infiltration of the surgical site with local anesthetics has provided transient benefit after craniotomy, but its effect on chronic pain has not been evaluated. Accordingly, we designed the present study to test the hypothesis that ropivacaine infiltration of the scalp reduces acute and persistent postoperative pain after intracranial tumor resection. This was a prospective, single-blinded study. Inclusion criteria were intracranial tumor resection, age > or = 18 or < or = 80 yr, and ability to understand and use a visual analog scale (VAS). Exclusion criteria were history of craniotomy, chronic drug abuse, and neurologic disorders. All eligible patients were randomly included in Group I (infiltration) or C (control). Postoperative analgesia was IV acetaminophen combined with nalbuphine. At the end of the surgery, Group I received an infiltration of the surgical site with 20 mL of ropivacaine 0.75%. Acute pain was evaluated hourly by VAS during the first 24 h. The analgesic effect of ropivacaine was evaluated based on total consumption of nalbuphine and VAS scores. The incidence of persistent pain and neuropathic pain was assessed at the 2-mo postoperative evaluation. We used the Student's t-test to compare total nalbuphine consumption, repeated measures analysis of variance with post hoc Bonferroni t-test for VAS score and the Fisher's exact test for chronic and neuropathic pain. Fifty-two patients were enrolled, 25 in Group I and 27 in Group C. Demographic and intraoperative data were similar between groups. Group I showed a nonsignificant trend toward reduced nalbuphine consumption during the first postoperative day, 11.2 +/- 9.2 mg vs 16.6 +/- 11.0 mg for Group C (mean +/- SD, P = 0.054). VAS scores were significantly higher in Group C. Two months after surgery, persistent pain was significantly lower in Group I, 2/24 (8%) vs 14/25 (56%), P = 0.0003. One patient (4.1%) in Group I versus six (25%) patients in Group C (P = 0.04) experienced neuropathic pain. Because pain is moderate after intracranial tumor resection, there is limited interest in scalp infiltrations with ropivacaine in the acute postoperative period. Nevertheless, these infiltrations may be relevant for the rehabilitation of neurosurgical patients and their quality of life by limiting the development of persistent pain and particularly neuropathic pain.

Effects of intraarticular ropivacaine and morphine on lipopolysaccharide‐induced synovitis in horses

ObjectiveTo compare the intraarticular (IA) analgesic effects of ropivacaine and morphine in horses with experimentally induced synovitis. Study designRandomized, blinded cross‐over design. AnimalsTwelve healthy mixed breed horses between 8–15 years old. MethodsSynovitis was induced in the left radio‐carpal joint with an injection of lipopolysaccharide (Escherichia coli 055:B5). Six hours later, the horses were treated with an IA injection of 40 mg of ropivacaine (ROPI), 40 mg of morphine (MOR), 20 mg of ropivacaine added to 20 mg of morphine in saline (RM) or 4 mL of saline (SAL), as control. Analgesia was measured subjectively using a numerical rating scale, a simple descriptive scale, pain upon maximal flexion of the carpus and by the range of motion exhibited by the affected joint. Data are reported as mean ± SD and were analyzed using anova. Blood and synovial data were analyzed by split plots in time with units (treatments: SAL, ROPI, MOR and RM) and subunits (times: T0–24), in a completely randomized design with six replicates. Mean comparisons were made by Tukey's test; differences were considered significant at p < 0.05. ResultsRopivacaine had a clinical analgesic effect with a relative short duration (∼2.5 to 3.5 hours). Morphine had a slower onset of action than ROPI, but a stronger analgesic effect of longer duration. The RM showed an earlier onset of action than MOR and had a strong analgesic effect for the 24‐hour post‐injection period. All treatments caused a significant decrease in total nucleated cells compared with the control, 24 hours after administration. Conclusions and clinical relevanceMorphine alone or in combination with ropivacaine produced a strong analgesic effect of prolonged duration, which may offer pain relief for acute synovitis for at least 24 hours.

Pharmacokinetics and Analgesic Effect of Ropivacaine during Continuous Epidural Infusion for Postoperative Pain Relief

The pharmacokinetics and clinical efficacy of ropivacaine (2.5 mg/ml) during a 24-h continuous epidural infusion for postoperative pain relief in 20 patients scheduled for abdominal hysterectomy were characterized using an open-label, increasing-dose design. Through an epidural catheter inserted at T10-T12, a test dose of 7.5 mg ropivacaine was given 3 min before a bolus dose of 42.5 mg and immediately followed by a 24-h continuous epidural infusion with either 10 or 20 mg/h. Peripheral venous plasma samples were collected up to 48 h after infusion, and urinary excretion was followed up to the end of infusion. Postoperative pain at rest, on coughing, and at mobilization was assessed by means of a visual analog scale 2,4,6,8,12, and 24 h after the end of surgery. Sensory (pinprick) and motor block (modified Bromage scale) were assessed at the same intervals. The total plasma concentrations of ropivacaine increased markedly and consistently during the 24-h epidural infusion, in contrast to stable unbound concentrations. Both total and unbound plasma concentrations at the end of infusion were proportional to the total dose, although only the latter was proportional to the infusion rate. The total and unbound plasma clearance was independent of dose. Total mean clearance decreased on average by 21% (P < 0.001) during the last 12 h of epidural infusion, i.e., from 539 +/- 191 ml/min to 418 +/- 138 ml/min, indicating time-dependent kinetics. The unbound clearance also varied between estimates after 8 h of infusion and the end of treatment, i.e., a 5.3% decrease from 10.4 +/- 5.3 l/min to 9.5 +/- 3.9 l/min (P < 0.05). The unbound fraction of ropivacaine in plasma decreased during treatment, and this was related to the increase in alpha1-acid glycoprotein concentration. Pain was generally well controlled, and median visual analog scale scores during mobilization were less than 30 mm in patients receiving ropivacaine at 20 mg/h. The pharmacokinetics of ropivacaine were independent of dose, but total clearance decreased with time over 24 h. The consistent increase in total plasma concentration during the postoperative epidural infusion contrasted to much less variation in the unbound plasma concentrations of ropivacaine.