Keramidas Evangelos G, Rodopoulou Stavroula G
Athens, Greece From the Department of Plastic Surgery, Microsurgery and Burn Unit, General State Hospital of Athens "G. Gennimatas."
Plast Reconstr Surg. 2007 Jun;119(7):2148-2152. doi: 10.1097/01.prs.0000260725.33655.88.
Ropivacaine is a relatively new long-acting amide local anesthetic. Since its introduction in 1996, it has been used for subcutaneous infiltration; epidural, intrathecal, and peripheral nerve block surgery; and postoperative analgesia. However, it has never been used for digital blocks. This prospective, randomized, double-blind study compares the digital block results following the administration of 2.5 ml of 0.75% ropivacaine solution and 2.5 ml of 2% lidocaine solution.
From March of 1999 to March of 2001, 70 adult patients who underwent immediate reconstruction for traumatic injuries of the digits were prospectively randomized into two groups. Group A (n = 35) received 2.5 ml 0.75% ropivacaine and group B (n = 35) received 2.5 ml of 2% lidocaine for digital anesthesia. Onset time of anesthetic action, duration of anesthesia, time until first postoperative requirement for pain medication, and digital-brachial artery systolic blood pressure index were recorded and evaluated. Local vascular effects were observed visually.
No side effects were observed. Lidocaine had the quickest onset of anesthesia, with a mean time of 1.3 minutes (range, 1 to 2.7 minutes). Ropivacaine had a mean onset time of 4.5 minutes (range, 3.5 to 5.5 minutes). The mean duration of postoperative anesthesia for lidocaine was 2.4 hours (range, 1.4 to 4 hours), compared with 21.5 hours for ropivacaine and less requirement for analgesics during the first 24 postoperative hours (p < 0.05) (range, 19 to 23 hours). No significant difference was found between the digital-brachial artery systolic blood pressure index of group A compared with group B.
Ropivacaine can be used effectively as a local anesthetic for digital nerve blocks. It can be used for prolonged operations (>1.5 hours) without additional injections and can provide long-lasting postoperative analgesia.
罗哌卡因是一种相对较新的长效酰胺类局部麻醉药。自1996年引入以来，它已用于皮下浸润、硬膜外、鞘内和周围神经阻滞手术以及术后镇痛。然而，它从未用于指神经阻滞。这项前瞻性、随机、双盲研究比较了给予2.5毫升0.75%罗哌卡因溶液和2.5毫升2%利多卡因溶液后的指神经阻滞效果。
从1999年3月至2001年3月，70例因手指创伤性损伤接受即刻重建手术的成年患者被前瞻性随机分为两组。A组（n = 35）接受2.5毫升0.75%罗哌卡因，B组（n = 35）接受2.5毫升2%利多卡因用于指神经麻醉。记录并评估麻醉起效时间、麻醉持续时间、术后首次需要止痛药物的时间以及指-肱动脉收缩压指数。肉眼观察局部血管效应。
未观察到副作用。利多卡因的麻醉起效最快，平均时间为1.3分钟（范围为1至2.7分钟）。罗哌卡因的平均起效时间为4.5分钟（范围为3.5至5.5分钟）。利多卡因术后麻醉的平均持续时间为2.4小时（范围为1.4至4小时），而罗哌卡因的为21.5小时，且术后24小时内对镇痛药的需求较少（p < 0.05）（范围为19至23小时）。A组与B组的指-肱动脉收缩压指数之间未发现显著差异。
罗哌卡因可有效地用作指神经阻滞的局部麻醉药。它可用于长时间手术（>1.5小时）而无需额外注射，并可提供持久的术后镇痛。
