Ropivacaine: An important anesthetic agent for slow infusion and other forms of tumescent anesthesia

BACKGROUND. Reliable, long-acting local anesthetics reduce postoperative pain and make it easier to plan surgery. This is especially true when slow infusion tumescent anesthesia (SITA) is used. The anesthetic agent ropivacaine appears to meet the requirements of SITA especially well. OBJECTIVE. This study examined the clinical effectiveness and tolerance of ropivacaine in healthy volunteers and in a large number of patients. METHODS. Ropivacaine's clinical action was investigated as follows: Thirty healthy volunteers received 30 mi of three solutions of lidocaine alone, lidocaine mixed with ropivacaine, and ropivacaine alone, all containing epinephrine 1:1,000,000. The local anesthetic effects were studied. Ropivacaine was used clinically both alone and with different mixtures of ropivacaine and prilocaine, containing epinephrine 1:1,000,000, in a total of 5220 surgical procedures of all kinds in 3270 patients. The maximum dose of ropivacaine was 300 mg. No patient was excluded from this kind of anesthesia. Patient ages ranged from 5 to 95 years (median 54). No suprarenin was added for nerve blocks of the fingers and penis. RESULTS. Ropivacaine acted more than twice as long as lidocaine. Clinical application was completely free of side effects and complications and involved a very low rate of postoperative bleeding. The patients remained free of pain as a rule for many hours. CONCLUSION. We regard ropivacaine as a major step forward in the use of local anesthesia.