Volume of ropivacaine 0.2% and common peroneal nerve block duration: a randomised, double-blind cohort trial in healthy volunteers
Volume of ropivacaine 0.2% and common peroneal nerve block duration: a randomised, double-blind cohort trial in healthy volunteers
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DOI：
10.1111/anae.14400
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发表时间：
2018-11-01
期刊：
影响因子：
10.7
通讯作者：
Lange, K. H. W.
中科院分区：
文献类型：
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作者：
Christiansen, C. B.;Madsen, M. H.;Lange, K. H. W.
低浓度罗比卡因用于周围神经阻滞的容量-持续时间关系尚不清楚，尽管低浓度罗比卡因在临床上的使用越来越多。我们观察了0.2%罗比卡因对腓总神经阻滞时间的影响。在伦理委员会的批准下，60名同意的健康志愿者被随机分配到5个体积的罗比卡因(2.5，5.0，10，15或20ml)中的一个，在超声引导下，通过导管在腓总神经附近注射(10ml.min(-1))。我们的主要结果是感觉阻断的持续时间，定义为对冷刺激不敏感。我们的次要结果是运动阻滞的持续时间。从阻断开始到完全缓解，每小时评估一次结果。组间差异用单因素方差分析进行检验，然后以20ml干预组为参照进行回归分析。不同组间的阻滞持续时间差异显著(p<；0.0001)。感觉传导阻滞持续时间分别为9.2(3.3)、12.5(3.0)、15.5(4.4)、17.3(3.5)和17.3(4.6)h，运动阻滞持续时间(SD)分别为3.3(2.1)、7.2(2.5)、9.2(2.2)、12.7(2.5)和12.5(2.5)h。达到阈值容量后，对神经阻滞时间无影响(感觉阻滞10ml，运动阻滞15ml)。我们的结论是，增加0.2%罗比卡因的容量对腓总神经的感觉和运动阻滞时间都有天花板效应。
The volume-duration relationship using low concentrations of ropivacaine for peripheral nerve blocks is unknown, even though low concentrations of ropivacaine are increasingly used clinically. We investigated the effect of ropivacaine 0.2% on common peroneal nerve block duration. With ethical committee approval, 60 consenting, healthy volunteers were randomly allocated to receive one of five volumes of ropivacaine 0.2% (2.5, 5.0, 10, 15 or 20 ml) administered by ultrasound-guided, catheter-based injection (at 10 ml.min(-1)) near the common peroneal nerve. Our primary outcome was duration of sensory block, defined by insensitivity to a cold stimulus. Our secondary outcome was duration of motor block. Outcomes were assessed every hour from onset of block to complete remission. Intergroup differences were tested using one-way ANOVA followed by regression analyses using the 20 ml intervention group as reference. Block durations varied significantly (p < 0.0001) between groups. Mean (SD) sensory block durations were 9.2 (3.3), 12.5 (3.0), 15.5 (4.4), 17.3 (3.5) and 17.3 (4.6) h. Mean (SD) motor block durations were 3.3 (2.1), 7.2 (2.5), 9.2 (2.2), 12.7 (2.5) and 12.5 (2.5) h. Regression analysis showed that the effect of volume on block duration was progressively smaller with increasing volume, reaching a threshold volume above which there was no effect on nerve block duration (10 ml for sensory block and 15 ml for motor block). We conclude that there is a ceiling effect of increasing volume of ropivacaine 0.2% on both sensory and motor block duration of the common peroneal nerve.