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Epinephrine 4 microg/mL added to a low-dose mixture of ropivacaine and fentanyl for lumbar epidural analgesia after total knee arthroplasty

BACKGROUND: Epinephrine 2 microg/mL added to a local anesthetic-opioid mixture has been found to improve postoperative continuous epidural analgesia at the thoracic (TEA) but not at lumbar (LEA) level. Therefore, we studied whether a higher dose of epinephrine could improve LEA. METHODS: Patients received LEA comprising of ropivacaine 1.8 mg/mL and fentanyl 3 microg/mL either without (group RF, n = 32) or with epinephrine 4 microg/mL (group RFE, n = 31) for 2 days after total knee arthroplasty. Rescue pain medication consisted of epidural top-ups (study mixture) and parenteral oxycodone. RESULTS: Total amounts of epidurally administered drugs were significantly higher in group RFE. Otherwise, the groups did not differ significantly regarding pain relief and side effects. CONCLUSIONS: As part of the multimodal pain treatment used, the epidural adjuvant epinephrine 4 microg/mL (12-32 microg/h) did not improve LEA after total knee arthroplasty

Keywords : administration & dosage,Aged,Amides,Analgesia,Epidural,Analgesics,Analgesics,Opioid,Anesthetics,Local,Arthroplasty,Arthroplasty,Replacement,Knee,Double-Blind Method,Drug Therapy,Combination,Epinephrine,Female,Fentanyl,Humans,Lumbar Vertebrae,Male,methods,Middle Aged,Oxycodone,Pain Measurement,Pain,Postoperative,prevention & control,Ropivacaine,therapeutic use,Time Factors,Treatment Outcome,, 4,Microg/Ml,Added, repetitive strain injury symptoms in hand

Date of Publication : 2008 Jan

Authors : Forster JG;Lumme HM;Palkama VJ;Rosenberg PH;Pitkanen MT;

Organisation : Department of Anaesthesiology and Intensive Care Medicine, Helsinki University Hospital, Finland. johannes.forster@hus.fi

Journal of Publication : Anesth Analg

Pubmed Link : https://www.ncbi.nlm.nih.gov/pubmed/18165594

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