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 83
- Downloads 0
EFFECTIVENESS OF EDUCATIONAL PROGRAMME ON KNOWLEDGE REGARDING EFFECT OF THERAPEUTIC HYPOTHERMIA IN POST CARDIACARREST PATIENTS AMONG STAFF NURSES WORKING IN CRITICAL CARE AREAS
INTRODUCTION: To improve the survival after a cardiac-arrest the key is the quality of emergency care in the hospitals. Early CPR, early fibrillation, early transfer to specialist care of offering the best post-resuscita...
CAVUM SEPTUM PELLUCIDUM IN VARIOUS NEUROLOGICAL DISORDERS AMONG CHILDREN - A DESCRIPTIVE STUDY
OBJECTIVE: To study the association of persistence of cavum septum pellucidum in various neurological disorders among children above one year of age attending pediatric neurology outpatient department of Stanley Hospital...
Work Life Balance of Women Employee: A Literature Review
Profession and objectives are the most imperative elements in life. The greater part of the ladies are impending forward to work keeping in mind the end goal to bolster their gang. This change is presently characteristic...
ROLE OF MRI IN PRE OPERATIVE STAGING OF CARCINOMA ENDOMETRIUM
According to current consensus, early stage endometrial cancer does not require nodal dissection. The key factor is proper selection of cases with early stage carcinoma pre-operatively to avoid extensive surgery. Aim-Aim...
E-BANKING SERVICES UTILISATION PATTERN AMONG CUSTOMERS IN COIMBATORE CITY
Technology-based self-service has greatly changed the way service firms and consumers interact, and are raising a host of research and practice issues related to the delivery of e-service which has become increasingly im...