Key result
Intrathecal 12 mg ropivacaine with fentanyl resulted in a longer onset time of sensory block (3.17 vs 2.52 min, p<0.01) and less motor block than 8 mg bupivacaine.
Why the study?
Does 12 mg ropivacaine with 20 µg fentanyl compared to 8 mg bupivacaine with 20 µg fentanyl improve haemodynamic stability and alter block characteristics in geriatric patients undergoing hip arthroplasty?
RCT (n=60)
randomly assigned
Does 12 mg ropivacaine with 20 µg fentanyl compared to 8 mg bupivacaine with 20 µg fentanyl improve haemodynamic stability and alter block characteristics in geriatric patients undergoing hip arthroplasty?
Absolute Event Rate: 3.17% vs 2.52%
p-value: p=< 0.01
In geriatric patients undergoing hip arthroplasty, spinal anaesthesia with 12 mg ropivacaine and 20 µg fentanyl provides sufficient block with fewer haemodynamic side effects and less motor block compared to 8 mg bupivacaine with 20 µg fentanyl.
Supports ropivacaine-fentanyl for adequate block with less motor block in geriatric hip arthroplasty; extends RCT comparisons versus bupivacaine.
OBJECTIVE: The aim of this study was to compare the haemodynamic and anaesthetic effects of 12 mg ropivacaine and 8 mg bupivacaine, both with 20 microg fentanyl, in spinal anaesthesia for major orthopaedic surgery in geriatric patients. SUBJECTS AND METHODS: Sixty American Society of Anesthesiologists (ASA) II-III patients scheduled for hip arthroplasty were randomly assigned to receive an intrathecal injection of either 12 mg ropivacaine with 20 microg fentanyl (group R, aged 70 +/- 7 years, range 67-89) or 8 mg hyperbaric bupivacaine with 20 microg fentanyl (group B, aged 69 +/- 6 years, range 66-92). Motor and sensory block, haemodynamics and side effects were recorded. RESULTS: Mean levels of sensory block were similar, but the onset time of sensory block in group B (2.52 +/- 0.69 min) was shorter than that in group R (3.17-0.72 min); the difference was statistically significant (p < 0.01), and the number of patients who had motor Bromage scale 3 in group B (24) was greater than in group R (16). The difference was also statistically significant (p < 0.05). Systolic and diastolic arterial pressures (SAP, DAP) and heart rate (HR) decreased after the block in both groups. SAP (after the 60th and 120th min of block), DAP (all measurement times), and HR (after the 20th, 25th and 30th min of block) were lower in group B than in group R. CONCLUSIONS: The data showed that 12 mg of ropivacaine and 8 mg of bupivacaine with 20 microg fentanyl in spinal anaesthesia can provide sufficient motor and sensory block for major orthopaedic surgery in geriatric patients. However, ropivacaine caused less motor block and haemodynamic side effects than bupivacaine during the procedure.
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Ertürk et al. (2010) conducted an RCT in hip arthroplasty (n=60). Ropivacaine with fentanyl vs. 8 mg hyperbaric bupivacaine with 20 µg fentanyl was evaluated on onset time of sensory block (p=< 0.01). Intrathecal 12 mg ropivacaine with fentanyl resulted in a longer onset time of sensory block (3.17 vs 2.52 min, p<0.01) and less motor block than 8 mg bupivacaine.
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