Govil Nishith, Tripathi Mukesh, Goyal Tarun, Bhardwaj Bharat B, Krishna Vamshi, Choudhury Arghya K
Department of Anaesthesiology, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India.
Department of Anaesthesiology, All India Institute of Medical Sciences (AIIMS), Mangalagiri, Andhra Pradesh, India.
J Anaesthesiol Clin Pharmacol. 2022 Jan-Mar;38(1):84-90. doi: 10.4103/joacp.JOACP_112_20. Epub 2021 Sep 27.
The aim of this study was to establish noninferiority of 10 mL of 0.5% ropivacaine as compared to 20 mL of 0.5% ropivacaine; for choosing right dose in adductor canal block (ACB) after knee arthroplasty (KA), this trial was conducted.
Forty patients undergoing bilateral KA with postoperative ultrasound-aided ACB were randomized: Group A patients received 20 mL 0.5% ropivacaine in the right limb and 10 mL 0.5% ropivacaine in the left limb. Group B patients received 10 mL of 0.5% ropivacaine in the right limb and 20 mL of 0.5% ropivacaine in the left limb. Catheter is positioned for intermittent boluses every 12-h up to 48 h.
In the final analysis (excluding six patients) based on split-body design between Group I (comprising 34 limbs which received 20 mL of 0.5% ropivacaine) and Group II (comprising 34 limbs which received 10 mL of 0.5% ropivacaine), baseline demographic data were collected. Length of the limb from anterior superior iliac spine (ASIS) to the base of the patella was comparable between two groups: Group I (in cm; 149 ± 1.63) versus Group II (in cm; 149.5 ± 1.51) ( = 0.49, 95% CI of - 1.98 to 0.98). Primary outcomes, that is, quadriceps muscle strength, show a significant difference ( < 0.025) at various timeline. Secondary outcome pain scores and degree of knee flexion at various time intervals showed no significant difference. There was zero incidence of fall of the patient and no significant complication due to catheter was reported leading to discontinuation of catheter use in both groups.
10 mL of 0.5% ropivacaine is noninferior to 20 mL of 0.5% ropivacaine in providing postoperative analgesia with preserved quadriceps muscle strength.
本研究旨在确定10毫升0.5%罗哌卡因与20毫升0.5%罗哌卡因相比是否具有非劣效性；为了在膝关节置换术（KA）后选择内收肌管阻滞（ACB）的合适剂量，进行了本试验。
40例行双侧KA且术后接受超声辅助ACB的患者被随机分组：A组患者右下肢接受20毫升0.5%罗哌卡因，左下肢接受10毫升0.5%罗哌卡因。B组患者右下肢接受10毫升0.5%罗哌卡因，左下肢接受20毫升0.5%罗哌卡因。放置导管以便每12小时进行一次间歇性推注，持续48小时。
在基于I组（包括34条接受20毫升0.5%罗哌卡因的肢体）和II组（包括34条接受10毫升0.5%罗哌卡因的肢体）的分体设计的最终分析（排除6名患者）中，收集了基线人口统计学数据。两组从髂前上棘（ASIS）到髌骨底部的肢体长度具有可比性：I组（单位：厘米；149±1.63）与II组（单位：厘米；149.5±1.51）（P = 0.49，95%CI为-1.98至0.98）。主要结局，即股四头肌力量，在不同时间点显示出显著差异（P < 0.025）。次要结局疼痛评分和不同时间间隔的膝关节屈曲程度无显著差异。两组患者跌倒发生率为零，且未报告因导管导致的严重并发症致使导管停用。
10毫升0.5%罗哌卡因在提供术后镇痛并保留股四头肌力量方面不劣于20毫升0.5%罗哌卡因。
