Xu Cheng, Gu Fei, Liu Yang, Chen Rui, Wang Chengyu, Lu Jie
Department of Anaesthesiology, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai, China.
Front Pharmacol. 2022 Aug 17;13:928227. doi: 10.3389/fphar.2022.928227. eCollection 2022.
The median effective analgesic concentration (MEAC) of ropivacaine in interscalene brachial plexus block (ISBPB) for postoperative analgesia after arthroscopic rotator cuff repair (ARCR) has not been determined. Therefore, this study aimed to evaluate the MEAC after ARCR using 10 ml ropivacaine. This study was conducted on 40 patients with American Society of Anesthesiologists grade I or II who had selective ARCR. The 10 ml ropivacaine was administered for determined, with an initial concentration of 0.3% using up-and-down sequential allocation. After successful or unsuccessful postoperative analgesia, the concentration of ropivacaine was decreased or increased by 0.05% in the next patient. We defined successful postoperative analgesia as a visual analog scale score of <4 at rest within the initial 8 h after ISBPB. The analytic techniques of linear, linear-logarithmic, exponential regressions and centered isotonic regression were used for calculating MEAC. The secondary outcomes was sufentanil consumption, time to 1st rescue analgesic, onset time of sensory block and motor block. The concentration of ropivacaine administered ranged from 0.1% to 0.35%. The MEAC from the four different methods (linear, linear-logarithmic, exponential regressions and centered isotonic regression) were 0.207% (95% CI, 0.168-0.355%), 0.182% (95% CI, 0.165-0.353%), 0.196% (95% CI, 0.154-0.356%), and 0.163%, respectively. Of the four models, exponential regression had the least residual standard error (0.0990). The MEAC derived from the four statistical models for 10 ml ropivacaine in ultrasound-guided ISBPB for postoperative analgesia was distributed within a narrow range of 0.163%-0.207%. The exponential regression model calculated by the goodness-of-fit test at a concentration of 0.196% best fits the study data. http://www.chictr.org.cn/showproj.aspx?proj=127449, identifier ChiCTR2100047978.
在关节镜下肩袖修复术（ARCR）后用于术后镇痛的肌间沟臂丛神经阻滞（ISBPB）中，罗哌卡因的半数有效镇痛浓度（MEAC）尚未确定。因此，本研究旨在评估使用10毫升罗哌卡因在ARCR后的MEAC。本研究纳入了40例美国麻醉医师协会I或II级择期行ARCR的患者。使用上下顺序分配法给予10毫升罗哌卡因，初始浓度为0.3%。术后镇痛成功或失败后，下一位患者的罗哌卡因浓度降低或升高0.05%。我们将术后镇痛成功定义为ISBPB后最初8小时内静息状态下视觉模拟量表评分<4分。采用线性、线性对数、指数回归和中心等渗回归分析技术计算MEAC。次要结局指标为舒芬太尼用量、首次补救镇痛时间、感觉阻滞和运动阻滞的起效时间。罗哌卡因的给药浓度范围为0.1%至0.35%。四种不同方法（线性、线性对数、指数回归和中心等渗回归）得出的MEAC分别为0.207%（95%CI，0.168 - 0.355%）、0.182%（95%CI，0.165 - 0.353%）、0.196%（95%CI，0.154 - 0.356%）和0.163%。在这四种模型中，指数回归的残差标准误差最小（0.0990）。超声引导下ISBPB用于术后镇痛的10毫升罗哌卡因，从四种统计模型得出的MEAC分布在0.163% - 0.207%的狭窄范围内。通过拟合优度检验计算得出的浓度为0.196%的指数回归模型最符合研究数据。http://www.chictr.org.cn/showproj.aspx?proj=127449，标识符ChiCTR2100047978
