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Revista Brasileira de Anestesiologia
Print version ISSN 0034-7094
NOVAES, Marcus Vinícius Martins; FRANCISCO, Carlos Roberto Lopes; PIMENTA, Karina Bernardi and LAVINAS, Paulo Sérgio Gomes. Comparison between 0.25% bupivacaine and 0.2% ropivacaine in epidural anesthesia for thoracic surgery. Rev. Bras. Anestesiol. [online]. 2001, vol.51, n.6, pp.493-502. ISSN 0034-7094. http://dx.doi.org/10.1590/S0034-70942001000600004.
BACKGROUND AND OBJECTIVES: Combined general/epidural anesthesia has been used for several surgical procedures. Little has been published in the literature about its use in thoracic surgery. This study aimed to evaluate hemodynamic and ventilatory effects of combined general/epidural anesthesia with 0.25% bupivacaine and 0.2% ropivacaine in patients submitted to thoracotomy METHODS: Participated in this prospective, comparative and randomized study 40 patients divided in two groups of 20. Each group received 10 ml of epidural local anesthetics. Group B received 0.25% bupivacaine and Group R received 0.2% ropivacaine. Epidural anesthesia was induced with the patients in lateral position, using the paramedian approach and a catheter for drug injection. General anesthesia was then induced in all patients with tracheal intubation. Hemodynamic and ventilatory parameters were evaluated in 9 moments. RESULTS: In Group B, systolic blood pressure was lower at moment 5 and diastolic blood pressure was lower at moments 1 and 5. The need for ephedrine to correct hypotension was 8/20 in Group B as compared to 6/20 in Group R. Upper airway peak pressures and isoflurane MAC values were higher at moments 5 and 6 in Group R. CONCLUSIONS: The association of thoracic epidural anesthesia and general anesthesia was safe and efficient for patients submitted to thoracotomy. Bupivacaine has produced a higher decrease in blood pressure and lower peak airway pressures as compared to ropivacaine.
Keywords : ANESTHETICS, Local [bupivacaine]; ANESTHETICS, Local [ropivacaine]; ANESTHETIC TECHNIQUES, Regional [thoracic epidural].