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A Comparison of Epidural Ropivacaine with Lidocaine for Cesarean Section (C/S)
Abstract Number: S 9
Abstract Type: Original Research
Introduction: Our practice has been to initiate epidural block with lidocaine, fentanyl and epinephrine for C/S. In this study, we compared the new long acting ropivacaine with lidocaine to determine if ropivacaine can be introduced for routine use for epidural anesthesia for C/S.
Methods: Following IRB approval, 88 parturients scheduled for C/S with epidural anesthesia were included. The pt’s were randomly allocated: GI 45 patients received ropivacaine 0.75% with fentanyl 5 mcg/ml; and epinephrine 5 mcg/ml. GII 43 patients received lidocaine 2% with fentanyl 5 mcg/ml and epinephrine 5 mcg/ml. Both groups received the anesthetic solution by gravity technique  into the needle via 22 inches extension tubing before insertion of the “Braun” 18 g closed-end catheter (B. Braun Medical Inc.) 5cm into the epidural space. Following a standard lumbar epidural approach, all pt’s received 3, 5, 5 & 5 ml of the anesthetic solution administered by gravity through the needle, followed by catheter insertion and administration of 3 ml via the catheter to a total of 21 ml. Values are mean±SD.
Results: Groups did not differ in age, weight or height, previous neuraxial blocks, distance of epidural space from the skin, time to T6-S5 sensory level, additional local anesthetic dose required, incidence of pruritus, sedation, nausea, vomiting, hypotension, and overall satisfaction. APGAR scores of babies in GI & GII were high & similar at both 1&5 min. All pt’s had satisfactory treatment for C/S and post C/S pain Table I.
Conclusions: These data show that the addition of epinephrine and fentanyl to epidural ropivacaine solution administered for C/S by gravity technique via the needle is associated with longer time to incision, but without prolonging the duration of surgery, and with no effect on time to T6 sensory level, quality of the block and overall satisfaction when compared to lidocaine. This epidural ropivacaine technique may be applied routinely for our elective C/S.
1. Cohen S et al. Anesth Analg 86:534, 1998