| Minimum effective volume of local anesthetic for shoulder analgesia by ultrasound-guided block at root C7 with assessment of pulmonary function. | |
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MedLine Citation:
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PMID: 20975468 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND AND OBJECTIVES: This study was performed to determine the minimum effective volume of ropivacaine 0.75% required to produce effective shoulder analgesia for an ultrasound (US)-guided block at the C7 root level with assessment of pulmonary function. METHODS: Using the Dixon and Massey up-and-down method study design, 20 patients scheduled for elective open shoulder surgery under combined general anesthesia and continuous interscalene brachial plexus block were included. Initial volume of ropivacaine 0.75% was 6 mL; block success or failure determined a 1-mL decrease or increase for the subsequent patient, respectively. General anesthesia was standardized. A continuous infusion of ropivacaine 0.2% was started at a rate of 6 mL/hr at 2 hrs after completion of surgery. Ventilatory function was assessed using spirometry, and movement of the hemidiaphragm was assessed by US. RESULTS: The minimum effective volume of local anesthetic in 50% and 95% of the patients was 2.9 mL (95% confidence interval, 2.4-3.5 mL) and 3.6 mL (95% confidence interval, 3.3-6.2 mL), respectively. Ventilatory function and hemidiaphragmatic movement was not reduced up to and including 2 hrs after completion of surgery, but 22 hrs after start of the continuous infusion of ropivacaine 0.2%, ventilatory function and hemidiaphragmatic movement were significantly reduced (P < 0.001). CONCLUSIONS: The minimum effective volume of local anesthetic for shoulder analgesia for a US-guided block at the C7 root level in 50% and 95% of the patients was 2.9 and 3.6 mL, respectively. Pulmonary function was unchanged until 2 hrs after completion surgery, but reduced 22 hrs after start of a continuous infusion of ropivacaine 0.2%. |
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Authors:
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Steven H Renes; Geert J van Geffen; Harald C Rettig; Mathieu J Gielen; Gert J Scheffer |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Regional anesthesia and pain medicine Volume: 35 ISSN: 1532-8651 ISO Abbreviation: Reg Anesth Pain Med Publication Date: 2010 Nov-Dec |
Date Detail:
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Created Date: 2010-10-26 Completed Date: 2011-02-03 Revised Date: 2012-01-31 |
Medline Journal Info:
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Nlm Unique ID: 9804508 Medline TA: Reg Anesth Pain Med Country: United States |
Other Details:
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Languages: eng Pagination: 529-34 Citation Subset: IM |
Affiliation:
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Department of Anesthesiology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands. s.renes@anes.umcn.nl |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Amides / administration & dosage* Analgesia / methods* Anesthetics, Local / administration & dosage* Cervical Vertebrae / ultrasonography Diaphragm / drug effects*, ultrasonography Double-Blind Method Female Humans Infusions, Parenteral Male Middle Aged Nerve Block* Netherlands Pain Measurement Pain, Postoperative / etiology, prevention & control* Prospective Studies Pulmonary Ventilation / drug effects* Shoulder / innervation*, surgery Shoulder Pain / etiology, prevention & control* Spirometry Time Factors Treatment Outcome Ultrasonography, Interventional* |
| Chemical | |
Reg. No./Substance:
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0/Amides; 0/Anesthetics, Local; 84057-95-4/ropivacaine |
| Comments/Corrections | |
Comment In:
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Reg Anesth Pain Med. 2011 May-Jun;36(3):311; author reply 311-2
[PMID:
21508798
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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