Skin temperature during sympathetic block: a clinical comparison of bupivacaine 0.5% and ropivacaine 0.5% or 0.75%. 2006

A Di Filippo, and V Natale, and F Del Po, and M Ciapetti, and F Bressan, and S Falchi
Department of Medical and Surgical Critical Care, Unit of Anaesthesia and Intensive Care, University of Florence, Italy.

Measurement of skin temperature can be used as an indicator of sympathetic blockade induced by neuraxial anaesthesia. The aim of the study was to test the skin temperature response to epidural administration of bupivacaine and different concentrations of ropivacaine. Forty-eight ASA class I-II patients undergoing herniorraphy were enrolled into a prospective, randomized, double-blind clinical trial. Patients were randomly allocated to receive epidural anaesthesia with a single dose of 18 ml of bupivacaine 0.5% (n=16); ropivacaine 0.5% (n=16), or ropivacaine 0.75% (n=16). A temperature probe was positioned on the skin of the thigh and skin temperature registered before epidural anaesthesia, every 10 minutes for the first hour after the epidural injection and every hour for the following four hours. Sensory blockade was assessed by pinprick and motor blockade using the Bromage scale. No significant difference was observed in sensory or motor blockade. A skin temperature rise of 1 to 1.8 degrees C compared with basal values was observed in all patients within the first hour. Temperature returned to basal values within four hours in the ropivacaine 0.5% group, within five hours in the ropivacaine 0.75% group, and remained 1 degrees C higher after five hours in the bupivacaine 0.5% group (P<0.01). The duration of sympathetic block is significantly shorter with ropivacaine than with bupivacaine.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D002045 Bupivacaine A widely used local anesthetic agent. 1-Butyl-N-(2,6-dimethylphenyl)-2-piperidinecarboxamide,Bupivacain Janapharm,Bupivacain-RPR,Bupivacaina Braun,Bupivacaine Anhydrous,Bupivacaine Carbonate,Bupivacaine Hydrochloride,Bupivacaine Monohydrochloride, Monohydrate,Buvacaina,Carbostesin,Dolanaest,Marcain,Marcaine,Sensorcaine,Svedocain Sin Vasoconstr,Bupivacain RPR
D004311 Double-Blind Method A method of studying a drug or procedure in which both the subjects and investigators are kept unaware of who is actually getting which specific treatment. Double-Masked Study,Double-Blind Study,Double-Masked Method,Double Blind Method,Double Blind Study,Double Masked Method,Double Masked Study,Double-Blind Methods,Double-Blind Studies,Double-Masked Methods,Double-Masked Studies,Method, Double-Blind,Method, Double-Masked,Methods, Double-Blind,Methods, Double-Masked,Studies, Double-Blind,Studies, Double-Masked,Study, Double-Blind,Study, Double-Masked
D005260 Female Females
D006550 Hernia, Femoral A groin hernia occurring inferior to the inguinal ligament and medial to the FEMORAL VEIN and FEMORAL ARTERY. The femoral hernia sac has a small neck but may enlarge considerably when it enters the subcutaneous tissue of the thigh. It is caused by defects in the ABDOMINAL WALL. Femoral Hernia,Femoral Hernias,Hernias, Femoral
D006552 Hernia, Inguinal An abdominal hernia with an external bulge in the GROIN region. It can be classified by the location of herniation. Indirect inguinal hernias occur through the internal inguinal ring. Direct inguinal hernias occur through defects in the ABDOMINAL WALL (transversalis fascia) in Hesselbach's triangle. The former type is commonly seen in children and young adults; the latter in adults. Inguinal Hernia,Inguinal Hernia, Direct,Inguinal Hernia, Indirect,Direct Inguinal Hernia,Direct Inguinal Hernias,Hernia, Direct Inguinal,Hernia, Indirect Inguinal,Hernias, Direct Inguinal,Hernias, Indirect Inguinal,Hernias, Inguinal,Indirect Inguinal Hernia,Indirect Inguinal Hernias,Inguinal Hernias,Inguinal Hernias, Direct,Inguinal Hernias, Indirect
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000077212 Ropivacaine An anilide used as a long-acting local anesthetic. It has a differential blocking effect on sensory and motor neurons. 1-Propyl-2',6'-pipecoloxylidide,AL 381,AL-381,LEA 103,LEA-103,Naropeine,Naropin,Ropivacaine Hydrochloride,Ropivacaine Monohydrochloride,Ropivacaine Monohydrochloride, (S)-isomer,1 Propyl 2',6' pipecoloxylidide,AL381,LEA103
D000577 Amides Organic compounds containing the -CO-NH2 radical. Amides are derived from acids by replacement of -OH by -NH2 or from ammonia by the replacement of H by an acyl group. (From Grant & Hackh's Chemical Dictionary, 5th ed) Amide

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