If you are experiencing problems downloading PDF or HTML fulltext, our helpdesk recommend clearing your browser cache and trying again. If you need help in clearing your cache, please click here . Still need help? Email help@ingentaconnect.com

Epidural ropivacaine – where are the benefits? A prospective, randomized, double-blind trial in patients with retropubic prostatectomy

$48.00 plus tax (Refund Policy)

Download / Buy Article:



In comparison with bupivacaine, ropivacaine exhibits comparable anaesthetic effects but with less motor impairment and systemic toxicity. However, the analgesic potency may differ. For example, ropivacaine during obstetric epidural analgesia provides an approximately 40% lower analgesic potency than bupivacaine. Equal visual analogue pain scores require significantly higher dosages of ropivacaine, and general statements about a favourable benefit–risk profile relative to that of bupivacaine may therefore have limited clinical impact. We addressed this topic in a male pain model by evaluating the analgesic efficacy of epidural ropivacaine 0.2% vs. bupivacaine 0.125% after retropubic prostatectomy. Methods: 

Forty patients scheduled for retropubic prostatectomy were randomly assigned to two groups (20 patients per group). In a double-blind prospective design, patient-controlled lumbar epidural analgesia was provided by ropivacaine 0.2% in the ropivacaine group and by bupivacaine 0.125% in the bupivacaine group. The primary endpoint was the total amount of local anaesthetic consumption. The secondary endpoints were the numeric rating scale scores for rest and dynamic pain and the degree of motor impairment. Results: 

Ropivacaine consumption was 60% higher (mean ± standard deviation, 1372.5 ± 108.3 mg) than that of bupivacaine (852 ± 75.2 mg) (P < 0.001). There were no significant differences in the numeric rating scale scores and motor impairment. Conclusions: 

In male patients, lumbar epidural administration of ropivacaine 0.2% after retropubic prostatectomy does not appear to provide benefits over bupivacaine 0.125%. Moreover, in view of the significantly higher drug requirements, general statements focusing on the favourable therapeutic index of ropivacaine may require critical analysis, at least during epidural administration.

Keywords: bupivacaine; epidural analgesia; local anaesthetic; ropivacaine; toxicity

Document Type: Research Article

DOI: http://dx.doi.org/10.1111/j.1399-6576.2006.01259.x

Affiliations: Department of Anaesthesiology, Johannes Gutenberg-University Mainz, Mainz, Germany

Publication date: March 1, 2007

Related content



Share Content

Access Key

Free Content
Free content
New Content
New content
Open Access Content
Open access content
Subscribed Content
Subscribed content
Free Trial Content
Free trial content
Cookie Policy
Cookie Policy
ingentaconnect website makes use of cookies so as to keep track of data that you have filled in. I am Happy with this Find out more