Effects of ropivacaine concentration on the spread of sensory block produced by continuous thoracic paravertebral block: a prospective, randomised, controlled, double-blind study

Anaesthesia. 2014 Mar;69(3):231-9. doi: 10.1111/anae.12531. Epub 2014 Jan 21.

Abstract

Factors affecting the distribution of continuous thoracic paravertebral block have never been examined. We designed this prospective, double-blind study to check whether continuous thoracic paravertebral block with a higher ropivacaine concentration would provide a wider segmental sensory block spread. Sixty consecutive patients undergoing pulmonary lobectomy or segmentectomy were randomly allocated to receive continuous paravertebral infusion of either 0.2% or 0.5% ropivacaine (6 ml.h(-1) ). The primary outcome was the number of anaesthetised dermatomes as determined by loss of cold sensation 24 h after surgery. Twenty-seven patients per group were included in the final analysis. The median (IQR [range]) number of anaesthetised dermatomes 24 h after surgery was 4 (3-6 [1-9]) with ropivacaine 0.2% and 4 (3-6 [2-11]) with ropivacaine 0.5% (p = 0.66). Contrary to our expectation, the segmental spread of sensory block produced by continuous thoracic paravertebral block does not depend on ropivacaine concentration.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Amides / administration & dosage
  • Amides / pharmacology*
  • Anesthesia, General
  • Anesthesia, Intravenous
  • Anesthetics, Intravenous
  • Anesthetics, Local / administration & dosage
  • Anesthetics, Local / pharmacology*
  • Dose-Response Relationship, Drug
  • Double-Blind Method
  • Female
  • Fentanyl
  • Humans
  • Lung / surgery
  • Male
  • Middle Aged
  • Nerve Block*
  • Postoperative Nausea and Vomiting / epidemiology
  • Prospective Studies
  • Ropivacaine
  • Ultrasonography, Interventional
  • Young Adult

Substances

  • Amides
  • Anesthetics, Intravenous
  • Anesthetics, Local
  • Ropivacaine
  • Fentanyl