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document
Ropivacaine versus lidocaine in digital nerve blocks : a prospective study . BACKGROUND 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 . METHODS 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 . RESULTS 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 . CONCLUSIONS 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 .
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Intervention_Pharmacological
Ropivacaine
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Intervention_Pharmacological
lidocaine
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Intervention_Pharmacological
Ropivacaine
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Intervention_Pharmacological
2.5 ml of 0.75 % ropivacaine solution
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Intervention_Pharmacological
2.5 ml of 2 % lidocaine solution
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Intervention_Surgical
reconstruction for traumatic injuries of the digits
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Intervention_Pharmacological
ropivacaine
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Intervention_Pharmacological
lidocaine
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Intervention_Pharmacological
Lidocaine
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Intervention_Pharmacological
Ropivacaine
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Intervention_Pharmacological
lidocaine
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Intervention_Pharmacological
ropivacaine
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Intervention_Pharmacological
Ropivacaine
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Outcome_Physical
Onset time of anesthetic action , duration of anesthesia , time until first postoperative requirement for
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Outcome_Pain
pain
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Outcome_Physical
medication , and digital-brachial artery systolic blood pressure index
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Outcome_Adverse-effects
Local vascular effects
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Outcome_Adverse-effects
side effects
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Outcome_Physical
onset of anesthesia
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Outcome_Physical
mean onset time
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Outcome_Other
mean duration of postoperative anesthesia
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Outcome_Physical
digital-brachial artery systolic blood pressure index
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Outcome_Other
effectively
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Participant_Sample-size
digital nerve blocks :
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Participant_Condition
From March of 1999 to March of 2001 , 70 adult patients who underwent immediate reconstruction for traumatic injuries of the digits
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Participant_Sample-size
digital nerve blocks .