Ropivacaine infusion in diabetics subject with peripheral arterial disease. A prospective study.

Abstract

BACKGROUND:

Peripheral arterial disease (PAD) predicts cardiovascular and cerebrovascular ischemic events. PAD treatment is aimed at reducing clinical symptoms, local tissue loss and at preventing complications.

AIMS:

To evaluated the effect of peridural analgesia on peripheral perfusion and pain control.

METHODS:

In 280 diabetic subjects with severe limb ischemia (65.7% males and 34.3% females, mean age 59.3±14.4 years) with a failure of medical treatment and contraindications to endovascular and/or surgical reperfusion, we performed a 30-day long peridural ropivacaine infusion, monitoring blood pressure, VAS and ABI periodically.

RESULTS:

During ropivacaine infusion VAS significantly decreased (from 4.06±0.343 to 1.96±0.413, p<0.001). Furthermore, in the 261 (93.2%) subjects achieving a VAS value ≤2 during infusion, the effect was maintained after infusion withdrawing. ABI significantly improved both during infusion (from 0.30±0.04 at baseline to 0.65±0.05 at T30, p<0.001) and after infusion withdrawing as compared with baseline values.

CONCLUSIONS:

30-day peridural analgesia with ropivacaine is a valuable therapeutic option in severe peripheral limb ischemia subjects with contraindication to surgery and with pharmacological therapy failure.

• Authors: M N D Di Minno, M Milone, A Russolillo, R Lupoli, A Di Minno, P Maietta, C Iacovazzo, G Salvatore, F Milone
• Journal: Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association (Exp Clin Endocrinol Diabetes) Vol. 121 Issue 2 Pg. 91-3 (Feb 2013) ISSN: 1439-3646 [Electronic] Germany
• PMID: 23147211 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York.

Chemical References

• Amides
• Anesthetics, Local
• Ropivacaine

Topics

• Adult
• Aged
• Amides (administration & dosage, adverse effects, therapeutic use)
• Anesthesia, Epidural
• Anesthetics, Local (administration & dosage, adverse effects, therapeutic use)
• Combined Modality Therapy (adverse effects)
• Diabetes Mellitus, Type 2 (complications)
• Diabetic Angiopathies (drug therapy, physiopathology, therapy)
• Drug Resistance
• Female
• Follow-Up Studies
• Humans
• Intermittent Claudication (etiology, prevention & control)
• Ischemia (complications, drug therapy, physiopathology, therapy)
• Leg (blood supply)
• Male
• Middle Aged
• Pain Measurement
• Peripheral Arterial Disease (complications, drug therapy, physiopathology, therapy)
• Prospective Studies
• Regional Blood Flow (drug effects)
• Ropivacaine
• Severity of Illness Index