MINIMUM EFFECTIVE ANESTHETIC CONCENTRATION (MEAC90) OF ROPIVACAINE IN ULTRASOUND GUIDED POPLITEAL SCIATIC NERVE BLOCK: A DOSE FINDING STUDY.
Journal Title: PARIPEX-Indian Journal of Research - Year 2017, Vol 6, Issue 12
Abstract
Background: Peripheral nerve blocks provide excellent regional anaesthesia for limb surgeries. Ultrasound guidance improves the precision and success of the peripheral nerve blocks; and appears to reduce both the concentration and volume of the local anaesthetics required for successful blocks. Objectives: This study was aimed at estimating the minimum effective anesthetic concentration of ropivacaine for ultrasound guided popliteal sciatic nerve block, successful in 90% of patients (MEAC ). 90 Materials and Methods: Design: Prospective, Interventional, Single Group, Double blind (subject and outcome assessor) study. Setting: The study was carried out in the Pre anesthesia procedure room of a tertiary care hospital in India. Patients: 47 ASA functional status 1 2 adult patients aged 18years and above, scheduled to undergo unilateral leg procedures of less than 90 minutes duration were included. Intervention: 47 patients scheduled to undergo lower leg surgeries received popliteal sciatic nerve block using 15 ml of ropivacaine in sub-paraneural plane starting with 0.2% w/v. The concentration of ropivacaine administered to the subsequent patient was determined by the effectiveness of nerve block in the previous patient, using the biased-coin design sequential updown method. If the nerve block was effective in a patient, then the next patient was randomized to receive either the same concentration as the previous patient(probability of 0.89) or a concentration 0.02% w/v less than the previous patient(probability of 0.11). If the nerve block was not effective in a patient, then ropivacaine concentration was increased by 0.02% w/v in the next patient. The block efficacy was assessed by an independent observer every 5 minutes for 30 minutes following the block. Measurements: Time to onset of block, Duration of procedure, Time to first rescue analgesic and complications of procedure were recorded. Results and Conclusion: Out of the 47 patients, 45 had successful blockade. Minimum Effective Anesthetic Concentration in 90% of subjects (MEAC ) was estimated to be 0.139%w/v (95% confidence interval, 0.129% - 0.158%). 90 Ultrasound guided sub-paraneural popliteal sciatic nerve block with 15 ml of 0.139% w/v ropivacaine can produce successful blockade in 90% of patients.
Authors and Affiliations
Davies Cherayath Vergheese, Mariam Koshy Thomas, Sahir Aftab
Keywords
Related Articles
- EP ID EP558714
- DOI -
- Views 81
- Downloads 0
Revised National Tuberculosis Control Programme : A Two Year Follow Up Study
Objective: To know the follow up status of tuberculosis patients after 2 years of completion of treatment in RNTCP. Material & Methods: Those patients of tuberculosis, who were registered between November 2002 to Novembe...
Outcome Analysis of Plating in Shaft of Humerus Fracture
Prospective study of thirty cases of shaft of humerus fractures treated by open reduction and internal fixation using Dynamic Compression plate are taken. Inclusion criteria are both comminuted and segmental closed shaft...
THE STUDY OF DRUG INTERACTION OF GLIPIZIDE WITH DOMPERIDONE ON BLOOD GLUCOSE LEVEL IN DIABETIC MICE
The prokinetic drug Domperidone is used to relieve nausea and vomiting, Gastroparesis, Parkinson's disease, Functional, dyspepsia, Lactation to increase the transit of food through the stomach (by increasing gastrointest...
The Influence of Naa on Embryo Germination of the Olive
Embryo germination was experimented over a period of three years as part of the embryogenesis of the olive endocarps. During April the endocarps were treated with immersion of NAA, C12H10O2, per 12 hours in three differe...
Effects of Static Magnetic Field on The Colony of Micro-Orgenism
The present study” Effects Of Static Magnetic Field On The Colony Of Micro-Orgenism” is an effort to understand the behavioural changes of physical system(yeast -Sacchromyce cerevisiae) under influence of different value...