Comparison of epidural Ropivacaine 0.75% and Ropivacaine 0.75% Plus Buprenorphine (0.5 ml) for total knee replacement surgery

Deepa Bulchandani, Dinesh Kumar Sahu, Reena Parampil


Aim and Objectives: To assess the comparison between ropivacaine and combination of ropivacaine with buprenorphine in terms of onset and duration of analgesia, cardiorespiratory effects, side effects and post-operative analgesia.

Methods: Total 60 adult patients of either sex, ASA grade I - II, schedule for total knee replacement surgery were enrolled in the study and randomized into two groups. Group R: received 14.5ml of 0.75% plain Ropivacaine + 0.5ml Normal saline (NS) making volume 15ml. Group RB: received 14.5ml of 0.75% plain Ropivacaine + Buprenorphine 150 mics (0.5ml) making volume 15ml. Onset of sensory-motor block, hemodynamic variables (HR, SBP, DPB, MAP, RR), duration of analgesia were recorded.

Results: The onset of sensory blockade was earlier in group R as compared to in group RB. The motor onset time was similar in both the groups. The mean hemodynamic parameters were comparable in both the groups. Duration of analgesia was prolonged in group RB as compared to group R. Group RB had more incidences of post-op vomiting (36.67%) and pruritus (3.3%) as compared to group R.

Conclusion: The addition of buprenorphine to epidural ropivacaine is a well tolerated, effective method for epidural anesthesia in patients undergoing unilateral total knee replacement surgery.


Ropivacaine, Buprenorphine, Epidural Cardiorespiratory effects, Post-operative analgesia, Knee replacement surgery

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. Grass JA. The role of epidural anesthesia and analgesia in postoperative outcome. Anesthesiology clinics of North America. 2000 Jun; 18(2):407-28.

. Choi P, Bhandari M, Scott J, Douketis J. Epidural analgesia for pain relief following hip or knee replacement. Cochrane Database Syst Rev. 2003; 3(3).

. Dene Simpson, Monique P. Curran, Vicki Oldfield, Gillian M. Keating. Ropivacaine A review of its use in regional anesthesia and acute pain management. Adis drug evaluation Drugs 2005;65(18):2675-717.

. Henry J. Mc Quay. Epidural analgesics in Pairic D. Wall, Ronald Melzack. Text Book of Pain. 3rd edition, Churchill Livingstone, 1994; 1025-26.

. Katz JA, Knarr D, Bridenbaugh PO.A double-blind comparison of 0.5% Bupivacaine and 0.75% Ropivacaine administered epidurally in humans. Reg. Anesth 1990;15(5):250-2.

. Peduto VA, Baroncini S, Montanini S, Proietti R, Rosignoli L, Tufano R, Casati A. A prospective, randomized, double-blind comparison of epidural levobupivacaine 0.5% with epidural Ropivacaine 0.75% for lower limb procedures. Eur J Anaesthesiol 2003; 20(12):979-83.

. Tuttle AA, Katz JA, Bridenbaugh PO, Quinlan R, Knarr D. A double-blind comparison of the abdominal wall relaxation produced by epidural 0.75% Ropivacaine and 0.75% Bupivacaine in gynecologic surgery. Reg Anesth. 1995;20(6):515-20.

. Bazin JE, Massoni C, Bruelle P, Fenies V, Groslier D, Schoeffler P. The addition of opioids to Local Anaesthetics in brachial plexus block: The comparative effects of morphine, buprenorphine and sufentanil. Anesthesia 1997;52:858-62.

. Kenneth D. Candido, Carlo D. Franco, Mohammad A. Khan, Alon P. Winnie, Durre S. Raja. Buprenorphine added to the local anesthetic for brachial plexus block to provide postoperative analgesia in outpatients. Reg Anesth Pain Med 2001;26:352-6.

. Candido KD, Winnie AP, Ghaleb AH, Fattouh MW, Franco CD. Buprenorphine added to the local anesthetic for axillary brachial plexus block prolongs postoperative analgesia. Reg Anesth Pain Med 2002;27(2):162-7

. Hirabayashi Go, Uchino Hiroyuki et al. Comparison of thoracic epidural Ropivacaine or Ropivacaine / Buprenorphine infusions for post-thoracotomy pain. Pain Clinic 2006;27(12):1581-5.

. McGlade DP, Kalpokas MV, Mooney PH, Buckland MR, Vallipuram SK, Hendrata MV, Torda TA. Comparison of 0.5% Ropivacaine and 0.5% Bupivacaine in lumbar epidural anesthesia for lower limb orthopaedic surgery. Anaesth Intensive Care. 1997;25(3):262-6.

. Ichiishi N. Hiraishi T, Hara O et al. Effect of epidural Buprenorphine on post operative respiratory function. Masui 1992; 41(10): 1574-9.

. Shin K, Choe H, Han Y, Kim D, Song H. Efficacy of the Epidural Buprenorphine for Postoperative Pain Control after Upper Abdominal Surgery. J Korean Pain Soc. 1993;6(2):213-219.

. Ito Takashi, Takahashi Hitoshi, Kinoshita Mayumi, Matsuura Naomi. Side Effects Caused by Epidural Buprenorphine in Young Patients Undergone Knee Surgery of about One Hour Duration. J Clin Anesth. 2000;24(7):1117-21.


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