[Ultrasound-guided single dose injection of 0.5% levobupivacaine or 0.5% ropivacaine for a popliteal fossa nerve block in unilateral hallux valgus surgery].

Abstract

OBJECTIVE:

To compare the perioperative analgesic efficacy of 0.5% levobupivacaine and 0.5% ropivacaine injected in a single dose to block the tibial and peroneal nerves for surgery using a posterior (popliteal fossa) approach.

MATERIAL AND METHODS:

Prospective randomized trial in patients undergoing hallux valgus surgery; anesthesia was provided by blocking nerves in the popliteal fossa with either 0.5% levobupivacaine or 0.5% ropivacaine. Variables studied were times until anesthetic block onset and reversal, need for additional sedation or peripheral block anesthetic, course of postoperative pain at 12, 24 and 48 hours and at 7 days, nighttime rest, need for additional analgesia, and patient satisfaction.

RESULTS:

Forty-six patients were enrolled. Times until onset of the sensory and motor blocks were similar in the 2 groups. For 57.1% of the patients, the sensory and motor block lasted 24 hours after surgery, with no between-group differences. The levobupivacaine group had less pain at rest 24 hours after surgery (mean [SD] visual analog scale score of 0.16 [0375] vs. 1.17 [1.88] in the ropivacaine group; P < .05). No patient reported severe pain or required additional analgesics. None were readmitted. More than 80% rested well at night. No between-group differences were observed.

CONCLUSIONS:

The use of a single dose of either levobupivacaine or ropivacaine to provide anesthesia for a popliteal approach to hallux valgus surgery is effective for controlling postoperative pain.

• Authors: E Pujol, A Faulí, M T Anglada, A López, M Pons, N Fàbregas
• Journal: Revista espanola de anestesiologia y reanimacion (Rev Esp Anestesiol Reanim) Vol. 57 Issue 5 Pg. 288-92 (May 2010) ISSN: 0034-9356 [Print] Spain
• Vernacular Title: Levobupivacaína 0.5% frente a ropivacaína 0.5% en el bloqueo poplíteo con dosis única de anestésico local por abordaje posterior dirigido por ecografía para cirugía de hallux valgus unilateral.
• PMID: 20527343 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial)

Chemical References

• Amides
• Analgesics
• Anesthetics, Local
• Ropivacaine
• Levobupivacaine
• Bupivacaine

Topics

• Aged
• Amides (administration & dosage)
• Analgesics (therapeutic use)
• Anesthetics, Local (administration & dosage)
• Bupivacaine (administration & dosage, analogs & derivatives)
• Female
• Hallux Valgus (surgery)
• Humans
• Injections
• Knee
• Levobupivacaine
• Male
• Middle Aged
• Nerve Block (methods)
• Pain Measurement
• Pain, Postoperative (drug therapy, epidemiology, prevention & control)
• Preanesthetic Medication
• Ropivacaine
• Sciatic Nerve (drug effects)
• Tibial Nerve (drug effects)
• Ultrasonography, Interventional