Use of ropivacaine for local anesthesia in plastic and cosmetic surgery: Experimental assessment and clinical findings [L'utilizzo della ropivacaina per l'anestesia locale in interventi di chirurgia plastica ed estetica: Valutazione sperimentale e riscontro clinico]

Among the main variables conditioning the feasibility of day surgery, special attention must be paid to the type of anesthesia to be administered to the patient. Modern local and locoregional anesthetic techniques have enabled a progressively rising number of operations to be performed with the patient awake. Local anesthetics do, however, differ from each other in terms of properties such as lag, potency, duration of action, vasoactive effect, toxic threshold. These characteristics direct the choice of the most appropriate local anesthetic, according to the type of operation to be performed. This study describes an instrumental comparison of the effects of Ropivacaine (at concentrations of 0.2% and 1%) Lidocaine and 0.9% physiological sodium chloride solution on vessel tone, following hypodermic infiltration in 40 healthy volunteers. Results were analysed in terms of duration and extent of the effect of the drugs on tissue perfusion, assessed by means of a laser-Doppler flowmeter. These data were then used to discuss the clinical application of Ropivacaine in the field of plastic and cosmetic surgery, assessed on the basis of 81 day surgery operations. The drug proved to be effective in terms of duration of anesthetic effect and also provided a good, prolonged analgesic effect in the postoperative period. Moreover, low vasodilation permitted relatively exsanguinate operations to be performed without the use of vasoconstrictors.