Vadagandla Koti, Jahagirdar Vinay, Rama Kaanthi, Qavi Danish
Critical Care, Medicover Hospital, Hyderabad, IND.
Internal Medicine, Gandhi Medical College and Hospital, Secunderabad, IND.
Cureus. 2020 Dec 22;12(12):e12229. doi: 10.7759/cureus.12229.
Background Ultrasound-guided peripheral nerve block provides direct visualization of nerve and reduces the complications associated with classical landmark guided technique, by reducing the dosage of local anesthetic drugs. This study aims to determine the minimum effective volume (MEAV) of 0.75% ropivacaine for ultrasound-guided axillary brachial plexus block. Methodology A total of 23 patients of age group 18-75 years belonging to ASA grade 1, 2, and 3 were selected based on inclusion criteria. The MEAV was determined by using Dixons & Massey Step-up and Step-down method. The initial volume was selected as 15 mL based on previous studies. Depending on block success or failure, 1 mL of the drug was decreased or increased. Block was assessed in terms of motor and sensory components. The study was aborted after attaining five cases of block failure, followed by five cases of a successful block. Results The MEAV to be given for a successful block in 50% of patients (MEAV50) was 8.62 mL (95%CI 3.54-9.89). The MEAV to be given for a successful block in 90% of patients (MEAV 90) was 11.82 mL (95% CI 9.9-75.7). Conclusion Ultrasound guidance reduces the dosage of local anesthetic drugs to be used and provides surgical anesthesia without any complications or adverse effects.
超声引导下的外周神经阻滞可直接显示神经，通过减少局部麻醉药物的用量，降低了与传统体表标志引导技术相关的并发症。本研究旨在确定0.75%罗哌卡因用于超声引导下腋路臂丛神经阻滞的最小有效容量（MEAV）。方法：根据纳入标准，选取23例年龄在18 - 75岁之间、ASA分级为1、2和3级的患者。采用迪克森和梅西的逐步递增和递减法确定MEAV。根据先前的研究，初始容量选择为15 mL。根据阻滞成功或失败情况，每次增减1 mL药物。从运动和感觉成分方面评估阻滞效果。在出现5例阻滞失败病例后，接着出现5例阻滞成功病例后，研究终止。结果：50%患者成功阻滞所需的MEAV（MEAV50）为8.62 mL（95%可信区间3.54 - 9.89）。90%患者成功阻滞所需的MEAV（MEAV90）为11.82 mL（95%可信区间9.9 - 75.7）。结论：超声引导可减少局部麻醉药物的使用剂量，并提供手术麻醉且无任何并发症或不良反应。
