The 90% minimum effective volume of 0.5 ropivacaine for ultrasound-guided supraclavicular brachial plexus block: A biased coin up-and-down design; [Das 90 %ige minimale effektive Volumen von 0,5 Ropivacain für die ultraschallgesteuerte supraklavikuläre Plexus-brachialis-Blockade: Ein „biased coin-up-and-down design“]

被引：0

作者：

Xuan Q. ^{[1
,3
]}

Pan R. ^{[2
]}

Wang A. ^{[3
]}

Li R. ^{[3
]}

Yang X. ^{[3
]}

Yin G. ^{[3
]}

机构：

[1] Department of Anesthesiology, The 960th Hospital of PLA, Jinan

[2] People’s Hospital of Juye County, Shandong Province, Heze

[3] Department of Anesthesiology, The First Affiliated Hospital of Dali University, Yunnan Province, Dali

来源：

Die Anaesthesiologie | 2023年 / 72卷 / Suppl 1期

关键词：

Biased coin up-and-down design; Brachial plexus block; Cross-sectional nerve area; Ropivacaine; Supraclavicular brachial plexus;

D O I：

10.1007/s00101-023-01344-7

中图分类号：

学科分类号：

摘要：

Background: Ultrasound-guided supraclavicular brachial plexus block is widely used in upper limb surgery; however, it requires a higher dose (20–30 mL) of local anesthetic. In this study, we aimed to determine the 90% minimum effective volume for ultrasound-guided supraclavicular brachial plexus block. Methods: All patients received an ultrasound-guided two-point injection of 0.5% ropivacaine at a starting volume of 0.18 mL/mm2 cross-sectional nerve area. In cases of a successful block, the next patient had the same volume with a probability of 0.89, and the volume was reduced by 0.04 mL/mm2 cross-sectional nerve area with a probability of 0.11. When the block failed, the dose was increased by 0.04 mL/mm2 cross-sectional nerve area. After 45 cases of successful blocks, the 90% minimum effective volume of local anesthetic was calculated using the centered isotonic regression function. Results: Centered isotonic regression analysis resulted in a 90% minimum effective volume and a 95% confidence interval of 0.189 mL/mm2 and 0.176–0.225 mL/mm2 for the supraclavicular brachial plexus block. Conclusion: A good blocking effect can be achieved with 0.189 mL/mm2 of 0.5% ropivacaine with more precise dosing, thereby reducing the risk of local anesthetic poisoning. © 2023, The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.

引用

页码：39 / 43

页数：4

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