A comparison of 0.5% ropivacaine and 1% mepivacaine for sciatic nerve block in the popliteal fossa

• Published in: Acta anaesthesiologica Scandinavica Vol. 45; no. 8; pp. 967 - 970
• Main Authors: Fernández-Guisasola, J., Andueza, A., Burgos, E., Plaza, A., Porras, M. C., Reboto, P., Rivera, J. C., García Del Valle, S.
• Format: Journal Article
• Language: English
• Published: Copenhagen Munksgaard International Publishers 01.09.2001; Blackwell
• Subjects: Adult; Aged; Amides - pharmacology; Anesthetics. Neuromuscular blocking agents; Ankle - surgery; Biological and medical sciences; Double-Blind Method; Female; Humans; local anesthetics: ropivacaine; lower limb orthopedic surgery; Male; Medical sciences; mepivacaine; Mepivacaine - pharmacology; Middle Aged; Nerve Block; Nerve block: popliteal nerve block; Neuropharmacology; Pharmacology. Drug treatments; Prospective Studies; Ropivacaine; Sciatic Nerve; Human; Diseases of the osteoarticular system; Blocking; Lower limb; Ropivacaine; Local anesthetic; Regional anesthesia; Orthopedic surgery; Mepivacaine; Organic amide; Popliteal space; Comparative study; Sciatic nerve
• ISSN: 0001-5172; 1399-6576
• DOI: 10.1034/j.1399-6576.2001.450808.x

Background: The purpose of this study was to compare anesthetic efficacy and postoperative analgesia of 0.5% ropivacaine and 1% mepivacaine for sciatic nerve block in the popliteal fossa (popliteal block). Methods: A prospective, double‐blind study was carried out in 58 adult patients scheduled for outpatient foot or ankle surgery. They were randomized to receive popliteal block with 40 ml of either 0.5% ropivacaine (group R) or 1% mepivacaine (group M). An atraumatic, Teflon‐coated needle connected to a neurostimulator was used to make a single puncture using a posterior approach. The times to onset of sensory and motor block, and the need for intraoperative sedation were recorded. Before discharge, patients were asked to document the time to first analgesic use, time to return of full sensation in the foot, and their evaluation of the technique. Results: Onset time (mean±standard deviation, 95% confidence interval) of both sensory block (6.5±5.1 min, 4.47–8.49, in group R and 6.2±3.7 min, 4.83–7.69, in group M) and motor block (6.6±4.4 min, 4.81–8.23, in group R and 7.9±4.1 min, 6.29–9.53, in group M) was similar in both groups. Postoperative analgesia lasted longer in group R (15.2±5.1 h, 13.25–17.21) than in group M (5.7±1.8 h, 5.01–6.41; P<0.001). Duration of sensory block was longer in group R (20.7±6.2 h, 18.51–23.01) than in group M (6.5±1.7 h, 5.86–7.16; P<0.001). Acceptance of the anesthetic procedure was similar in both groups. Conclusion: In this study we demonstrated that both 0.5% ropivacaine and 1% mepivacaine for popliteal block produced rapid, effective and safe anesthesia but postoperative analgesia was more long‐lasting with ropivacaine.