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Introducing ropivacaine into a department’s epidural analgesic practice. Improving acute pain service practice

Introducing ropivacaine into a department’s epidural analgesic practice. Improving acute pain... The results of introducing a new licensed local anaesthetic drug, ropivacaine, into routine practice were evaluated by measuring the efficacy and adverse effects of patient controlled epidural analgesia (PCEA), using ropivacaine 2mg/ml (R), or the mixtures in current use: fentanyl 5 (ॖg/ml with bupivacaine 1mg/ml (BF5) and fentanyl 10 (ॖg/ml) with bupivacaine 1mg/ml (BF10). All patients were nursed on general wards after surgery. For two months, 102 consecutive patients were studied. Pain scores at rest were significantly better in the fentanyl and bupivacaine groups, (mean rank R: 35.5, BF5: 22.7, BF10: 26.9, P<0.05). There was a significant correlation between patient controlled boluses and pain at rest and ( p < 0.001), and pain on moving ( p < 0.001). Nausea and vomiting was worse in the BF10 ( p < 0.05). Older patients demanded less analgesia ( p < 0.001). Postoperatively BF5 provided better pain relief with trends demonstrating fewer side‐effects and complications than BF10 or R. We now use fentanyl 5 (ॖg/ml and bupivacaine 1mg/ml as our standard epidural infusion mixture. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png British Journal of Clinical Governance Emerald Publishing

Introducing ropivacaine into a department’s epidural analgesic practice. Improving acute pain service practice

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Publisher
Emerald Publishing
Copyright
Copyright © 2000 MCB UP Ltd. All rights reserved.
ISSN
1466-4100
DOI
10.1108/14664100010361836
Publisher site
See Article on Publisher Site

Abstract

The results of introducing a new licensed local anaesthetic drug, ropivacaine, into routine practice were evaluated by measuring the efficacy and adverse effects of patient controlled epidural analgesia (PCEA), using ropivacaine 2mg/ml (R), or the mixtures in current use: fentanyl 5 (ॖg/ml with bupivacaine 1mg/ml (BF5) and fentanyl 10 (ॖg/ml) with bupivacaine 1mg/ml (BF10). All patients were nursed on general wards after surgery. For two months, 102 consecutive patients were studied. Pain scores at rest were significantly better in the fentanyl and bupivacaine groups, (mean rank R: 35.5, BF5: 22.7, BF10: 26.9, P<0.05). There was a significant correlation between patient controlled boluses and pain at rest and ( p < 0.001), and pain on moving ( p < 0.001). Nausea and vomiting was worse in the BF10 ( p < 0.05). Older patients demanded less analgesia ( p < 0.001). Postoperatively BF5 provided better pain relief with trends demonstrating fewer side‐effects and complications than BF10 or R. We now use fentanyl 5 (ॖg/ml and bupivacaine 1mg/ml as our standard epidural infusion mixture.

Journal

British Journal of Clinical GovernanceEmerald Publishing

Published: Dec 1, 2000

Keywords: Drugs; Patients; Hospitals; Pain

References