Christiansen, Claus Behrend;
Madsen, Mikkel Herold;
Mølleskov, Elise;
Rothe, Christian;
Lundstrøm, Lars Hyldborg;
Lange, Kai H.W.
The effect of ropivacaine concentration on common peroneal nerve block duration using a fixed dose : A randomised, double-blind trial in healthy volunteers
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Medientyp:
E-Artikel
Titel:
The effect of ropivacaine concentration on common peroneal nerve block duration using a fixed dose : A randomised, double-blind trial in healthy volunteers
:
A randomised, double-blind trial in healthy volunteers
Beteiligte:
Christiansen, Claus Behrend;
Madsen, Mikkel Herold;
Mølleskov, Elise;
Rothe, Christian;
Lundstrøm, Lars Hyldborg;
Lange, Kai H.W.
Erschienen in:
European Journal of Anaesthesiology, 37 (2020) 4, Seite 316-322
Sprache:
Englisch
DOI:
10.1097/eja.0000000000001112
ISSN:
0265-0215;
1365-2346
Entstehung:
Anmerkungen:
Beschreibung:
BACKGROUND The effect of local anaesthetic concentration on peripheral nerve block duration is unclear. Recent clinical trials found nerve blocks of equivalent duration despite changing local anaesthetic concentration but with a fixed local anaesthetic dose. A criticism of these studies is that the local anaesthetic doses used were above the proposed local anaesthetic dose-duration ceiling level, masking any potential effect of different local anaesthetic concentrations on nerve block duration. OBJECTIVE We investigated the effect of local anaesthetic concentration on nerve block duration using a fixed local anaesthetic dose below the local anaesthetic dose-duration ceiling level. We hypothesised that changing local anaesthetic concentration would affect nerve block duration. DESIGN Randomised, double-blind trial. SETTING Single-centre, academic hospital. PARTICIPANTS Healthy volunteers. INTERVENTIONS Each participant received an ultrasound-guided common peroneal nerve block with a fixed dose of 10 mg of ropivacaine dissolved in either 2.5, 5, 10, 15 or 20 ml of 0.9% saline according to group allocation, yielding local anaesthetic concentrations of 4, 2, 1, 0.67 and 0.5 mg ml−1. MAIN OUTCOME MEASURES The primary outcome was duration of sensory block defined as altered or no sensitivity to a cold stimulus. The secondary outcome was duration of motor block defined as either paresis or paralysis. Intergroup differences were tested using one-way Analysis of variance . RESULTS All participants had sensory block, and 56 out of 60 participants had motor block. From the highest to the lowest concentration groups, mean ± SD sensory block durations were 13.1 ± 2.7, 13.4 ± 3.3, 12.6 ± 3.9, 10.4 ± 2.9 and 11.0 ± 2.1 h (P = 0.073), and mean ± SD motor block durations were 8.5 ± 2.0, 7.9 ± 3.0, 6.1 ± 3.1, 5.9 ± 3.5, 4.0 1.9 h (P = 0.002). CONCLUSION In contrast to our hypothesis, we found no changes in mean sensory nerve block duration. However, local anaesthetic dilution resulted in reduced motor block duration. TRIAL REGISTRATION ClinicalTrials.gov, NCT03326609.