Comparison of Levobupivacaine and Ropivacaine for Femoral Neural Block
Status:
Terminated
Trial end date:
2011-10-01
Target enrollment:
Participant gender:
Summary
The anaesthetic management of patients undergoing total knee replacement is still not
standardised. Epidural analgesia is common, but is associated with bilateral lower limb motor
block and limited mobilisation. Spinal anaesthesia with intrathecal morphine provides good
pain relief, but only for 12 to 16 hours, and is often associated with nausea and vomiting.
Combined single injection femoral / sciatic blocks give good pain relief, but for a variable
length of time (between 12 and 24 hours).
In contrast, continuous femoral perineural infusion of local anaesthetic provides very good
pain relief for several days. Pain relief is maintained by a constant infusion of local
anaesthetic using an elastomeric ball. The investigators overriding aim is to develop a local
anaesthetic regimen which offers complete pain relief for at least 48 hours, yet allows full
mobilisation within 24 hours Given that ropivacaine may offer a more advantageous
pharmacological profile (less lipid solubility) compared to levobupivacaine, the
investigators feel it is pertinent to investigate the capacity of ropivacaine to prevent pain
relief after surgery. Thus, the investigators aim in this study is to compare the median
effective dose of levobupivacaine with the of ropivacaine for preventive pain relief after
total knee replacement. Further, calculation of the equipotent median effective dose's of
each local anaesthetic allied to objective measurement of quadriceps motor block using an
electromyogram will allow us to determine the sensory - motor split of each local
anaesthetic.
Phase:
Phase 4
Details
Lead Sponsor:
NHS Tayside
Treatments:
Anesthetics Anesthetics, Local Bupivacaine Levobupivacaine Ropivacaine