The estimation of minimum effective volume of 0.5% ropivacaine in ultrasound-guided interscalene brachial plexus nerve block: A clinical trial

Autor:	Prateek, Deepa Agarwal, Pushpender Sangwan, Himani Tak, Sarita Janweja, Kailash Mittal
Jazyk:	angličtina
Rok vydání:	2019
Předmět:	medicine.drug_class medicine.medical_treatment Phases of clinical research lcsh:RS1-441 lcsh:RD78.3-87.3 lcsh:Pharmacy and materia medica 03 medical and health sciences 0302 clinical medicine 030202 anesthesiology medicine Pharmacology (medical) General Pharmacology Toxicology and Pharmaceutics Local anesthetic business.industry Ropivacaine biased coin design 030208 emergency & critical care medicine ultrasonography Confidence interval Clinical trial Anesthesiology and Pain Medicine medicine.anatomical_structure lcsh:Anesthesiology Anesthesia Interscalene brachial plexus block Nerve block Upper limb business Brachial plexus medicine.drug
Zdroj:	Journal of Anaesthesiology Clinical Pharmacology, Vol 35, Iss 1, Pp 41-46 (2019)
ISSN:	0970-9185
Popis:	Background and Aims: Interscalene brachial plexus block (ISB) is the most commonly used mode of anesthesia for upper limb surgeries. Higher volume of local anesthetic used in ISB is associated with increased incidence of side effects, particularly phrenic nerve palsy. The aim of this study was to determine the minimum effective volume of 0.5% ropivacaine in 90% patients (MEV90) in ISB. Material and Methods: With target of 45 successful cases, phase 1 clinical trial was conducted based on the principles of biased coin design up-and-down method. After obtaining Ethical Committee's approval and patient's consent, patients with American Society of Anesthesiologist physical status (ASA PS) I and II, aged 18–60 years of either sex, undergoing upper arm surgery were recruited into the study until 45 successful cases. A 7 ml of 0.5% ropivacaine was used as starting dose, with patients receiving a higher or lower dose depending on previous patient's response. R package, SPSS 23, and Microsoft Excel were used for statistical analysis. Results: MEV90 of 0.5% ropivacaine for ISB was determined as 8.64 ml [confidence interval (CI) 95%, 8.28–9.02 ml]. Time for onset of sensory block and motor block was 5 min (5–15 min) and 10 min (5–20 min), respectively, while duration of analgesia was observed as 8.2 (4.8–12.5) h. Conclusions: This study observes that surgical anesthesia can be accomplished with 8.64 ml (95% CI: 8.28–9.02 ml) of 0.5% ropivacaine with ultrasound-guided ISB with multiple injection technique, without clinical deterioration in block onset and duration of analgesia.
Databáze:	OpenAIRE
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