Members do not see these Ads. Sign Up.

Hi Everyone,

I was wondering why bupivacaine 0.5% would be selected over ropivacaine 0.75% when mixed with betamethasone for relief of intermetatarsal bursitis? I have noticed this with the radiologists, and as I am aware ropivacaine has similar pharmacologic properties to bupivacaine and less cardiotoxic and CNS effects.

Cheers!!

 

Dear Andy,

A pertinent question that hopefully I can provide some guidance for as I wrote my master's dissertation on this topic.

In the systematic review we are (just about) to submit for publication we couldn't find evidence in the included studies of a difference in patient outcomes regarding what local anaesthetic is used with the steroid for IM bursitis. The dosages used (1-2mL in most studies) of LA negate the cardiotoxic risks.

I believe the radiologists motivations for using bupivacaine may be pecuniary rather than clinical.

I hope that helps and happy injecting.

Kind regards,


Steve Edwards
Registrar - Foot & Ankle Surgery

 

Hi Steve!

Thank you your reply. That is really interesting. I was searching high and low to get some further comparative information at dosages we would commonly use.

I look forward to reading the systematic review when it is published, and hopefully some happy injecting once this endorsement process is completed.

Cheers,

Andrew Slessar