Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Anaesthesia. 2016 Jun;71(6):700-5. doi: 10.1111/anae.13445. Epub 2016 Mar 4.
The aim of this study was to determine the minimum effective concentration of ropivacaine for ultrasound-guided supraclavicular brachial plexus block. Fifty-one patients undergoing arm surgery received double-injection ultrasound-guided supraclavicular block using ropivacaine 40 ml. The concentration of ropivacaine administered to each patient started at 0.225% and then depended on the response of the previous one, based on a biased coin design up-and-down sequential method. In case of failure, the ropivacaine concentration was increased by 0.025% w/v in the next subject. In the case of a successful block, the next patient was randomised to the same concentration or a concentration 0.025% w/v less. Success was defined as complete sensory blockade of the brachial plexus 30 min after the block together with pain-free surgery. The minimum effective ropivacaine concentration in 90% of subjects was 0.257% w/v (95% CI 0.241-0.280%).
本研究旨在确定罗哌卡因用于超声引导锁骨上臂丛阻滞的最低有效浓度。51 例行上肢手术的患者接受了双注射超声引导锁骨上臂丛阻滞，使用罗哌卡因 40ml。每位患者给予的罗哌卡因浓度从 0.225%开始，然后根据前一个患者的反应，采用偏倚硬币设计的上下序贯法决定。如果阻滞失败，则下一个患者的罗哌卡因浓度增加 0.025% w/v。如果阻滞成功，则下一个患者随机分配到相同浓度或浓度降低 0.025% w/v。成功定义为阻滞 30 分钟后臂丛神经感觉完全阻滞，同时手术无痛。90%的受试者的最低有效罗哌卡因浓度为 0.257% w/v（95%CI 0.241-0.280%）。
