Arthroplasty, Replacement, Knee Clinical Trial
Postoperative epidural analgesia (EA) is an effective and well-accepted modality of pain
relief technique after having total knee replacement operation(1,4). Patient controlled
epidural analgesia (PCEA) has been shown to be safe and effective in standard ward
setting(2) and results in reduced epidural analgesic requirements(3). Besides, it also bear
the advantage of avoidance of overdose, reduction of waiting times and involvement of
patients in their analgesic regimen(3). Both ropivacaine and levobupivacaine are the local
anaesthetic using in epidural analgesia which has been proven to be safe and effective(4).
0.2% Ropivacaine with 2ug/ml fentanyl has been used in our locality for more than 8 years.
Another local anaesthetics, levobupivacaine, a S-enantiomer of bupivacaine has come up in
Hong Kong, which has been proved to be safe, effective and may be better value for money.
These two drugs has been proven to have similar analgesic potency in using as EA for
postoperative pain relief for other operation(5,6,7) and for orthropaedics operation but in
different concentration(4). Concerns have been raised about the introduction of the
levobupivacaine in the departmental protocol. Objectives of this study are A)to determine
the equivalence of two local anaesthetics regimen ; 0.2% ropivacaine with 2ug/ml fentanyl
and 0.2% levobupivacaine with 2ug/ml fentanyl and B) to assess the cost-effectiveness of
using these two regimens.
The null hypothesis is that the difference of analgesic effect, presented with visual
analogue score, of two patient controlled epidural analgesia regimen, the 0.2% ropivacaine
with 2 ug/ml fentanyl and 0.2% levobupivacaine with 2ug/ml fentanyl is higher than the
threshold of 9 mm VAS. (8,9,10)
n/a
Allocation: Randomized, Endpoint Classification: Bio-equivalence Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator), Primary Purpose: Treatment
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