Continuous spinal anesthesia and postoperative analgesia with ropivacaine by spinocath catheter for patients undergoing lower abdominal operation

Objective To observe the safety and effect of continuous spinal anesthesia(CSA)and patient controlled analgesia(PCA)with ropivacaine by spinocath catheter for patients undergoing lower abdominal operation.Methods Fifty ASA Ⅰ-Ⅱ patients scheduled for lower abdominal operation were chosen.They received 0.75% ropivacaine for continuous spinal anesthesia by spinocath catheter that was placed at L2～3,and a loading dose of 1.5 to 2.5 ml was given.All cases were randomly divided into 3 groups for postoperative analgesia:16 cases in group A received 0.15% ropivacaine,16 cases in group B received 0.125% ropivacaine and a mixture of 0.125% ropivacaine+0.0002% fentanyl was used for 18 cases in group C.Background infusion rate was at 1.0 ml/h,bolus dose 0.5 ml and lock-out interval 30 min.PCA was maintained for 50 h.HR,MAP and SpO2 were continuously monitored during surgery,and onset time and level of analgesia were recorded.VAS pain score and movement of lower extremities(modified Bromage score)were assessed.Results HR,MAP and SpO2 in 50 patients were in normal range.Modified Bromage scores were class Ⅲ.VAS scores in groups A and C were lower than those in group B(P0.01).The recovery time of motor block in group A was obviously longer than that in groups B and C(P0.01).Conclusion Continuous spinal anesthesia and post-operative PCA with ropivacaine by spinocath catheter for patients undergoing lower abdominal operation is safe and effective.