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Journal cover: British Journal of Clinical Governance

British Journal of Clinical Governance

ISSN: 1466-4100
Currently published as: Clinical Governance: An International Journal
Incorporates: Clinical Performance and Quality Healthcare

Online from: 1996

Subject Area: Health Care Management/Healthcare

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Introducing ropivacaine into a department’s epidural analgesic practice. Improving acute pain service practice


Document Information:
Title:Introducing ropivacaine into a department’s epidural analgesic practice. Improving acute pain service practice
Author(s):T.J. Towell, (Clinical Nurse Specialist based at the Glenfield Hospital NHS Trust UHL, Leicester, UK), S. Maric, (Acute Pain Sister based at the Glenfield Hospital NHS Trust UHL, Leicester, UK), M. Jones, (Consultant, Anaesthetist Acute Pain Service based at the Glenfield Hospital NHS Trust UHL, Leicester, UK), R. Wyatt, (Consultant, Anaesthetist Acute and Chronic Pain Service, based at the Glenfield Hospital NHS Trust UHL, Leicester, UK), D.J.R. Duthie, (Senior Lecturer, University of Leicester, and a Consultant Anaesthetist, at the Glenfield Hospital NHS trust UHL, Leicester, UK)
Citation:T.J. Towell, S. Maric, M. Jones, R. Wyatt, D.J.R. Duthie, (2000) "Introducing ropivacaine into a department’s epidural analgesic practice. Improving acute pain service practice", British Journal of Clinical Governance, Vol. 5 Iss: 4, pp.217 - 221
Keywords:Drugs, Hospitals, Pain, Patients
Article type:Research paper
DOI:10.1108/14664100010361836 (Permanent URL)
Publisher:MCB UP Ltd
Abstract:The results of introducing a new licensed local anaesthetic drug, ropivacaine, into routine practice were evaluated by measuring the efficacy and adverse effects of patient controlled epidural analgesia (PCEA), using ropivacaine 2mg/ml (R), or the mixtures in current use: fentanyl 5 (µg/ml with bupivacaine 1mg/ml (BF5) and fentanyl 10 (µg/ml) with bupivacaine 1mg/ml (BF10). All patients were nursed on general wards after surgery. For two months, 102 consecutive patients were studied. Pain scores at rest were significantly better in the fentanyl and bupivacaine groups, (mean rank R: 35.5, BF5: 22.7, BF10: 26.9, P<0.05). There was a significant correlation between patient controlled boluses and pain at rest and (p < 0.001), and pain on moving (p < 0.001). Nausea and vomiting was worse in the BF10 (p < 0.05). Older patients demanded less analgesia (p < 0.001). Postoperatively BF5 provided better pain relief with trends demonstrating fewer side-effects and complications than BF10 or R. We now use fentanyl 5 (µg/ml and bupivacaine 1mg/ml as our standard epidural infusion mixture.



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