Minimum Effective Analgesic Concentration of Ropivacaine in Saphenous Block Guided by Ultrasound for Knee Arthroscopic Meniscectomy: Randomized, Double-Blind Study

After knee surgery, analgesia should be effective for mobilization and discharge. The primary objective of this study was to achieve the lowest effective analgesic concentration (MEC50 and MEC90) of ropivacaine for saphenous nerve block in arthroscopic meniscectomy. The secondary objective was to de...

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Published in:Journal of pain research 2021-01, Vol.14, p.53-59
Main Authors: Rey Moura, Ed Carlos, de Oliveira, Caio Marcio Barros, da Cunha Leal, Plinio, Kimiko Sakata, Rioko
Format: Article
Language:English
Subjects:
Alfentanil
Analgesics
Anesthesia
Blood pressure
Clinical Trial Report
Comparative analysis
Double-blind studies
Experiments
Knee
Pain
Patients
Probability
Remifentanil
Software
Surgery
Ultrasonic imaging
Variance analysis
Veins & arteries
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description After knee surgery, analgesia should be effective for mobilization and discharge. The primary objective of this study was to achieve the lowest effective analgesic concentration (MEC50 and MEC90) of ropivacaine for saphenous nerve block in arthroscopic meniscectomy. The secondary objective was to determine whether the block causes muscle weakness in the postoperative period. The study was randomized, comparative, and double-blind. Fifty-one patients between 18 and 65 years old of both sexes, ASA I or II, who underwent knee arthroscopic meniscectomy at São Domingos Hospital were included. Patients underwent saphenous nerve block with 10 mL of ropivacaine administered by using the up-and-down method. The ropivacaine concentration was determined based on the previous patient's response (a biased-coin up-down design sequential method). If a patient had a negative response, the concentration of ropivacaine was increased by 0.05% in the next patient; if the response was positive, the next patient was randomized to be administered the same concentration of ropivacaine or a 0.05% lower concentration. Successful block was defined as pain
doi_str_mv 10.2147/JPR.S282286
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The primary objective of this study was to achieve the lowest effective analgesic concentration (MEC50 and MEC90) of ropivacaine for saphenous nerve block in arthroscopic meniscectomy. The secondary objective was to determine whether the block causes muscle weakness in the postoperative period. The study was randomized, comparative, and double-blind. Fifty-one patients between 18 and 65 years old of both sexes, ASA I or II, who underwent knee arthroscopic meniscectomy at São Domingos Hospital were included. Patients underwent saphenous nerve block with 10 mL of ropivacaine administered by using the up-and-down method. The ropivacaine concentration was determined based on the previous patient's response (a biased-coin up-down design sequential method). If a patient had a negative response, the concentration of ropivacaine was increased by 0.05% in the next patient; if the response was positive, the next patient was randomized to be administered the same concentration of ropivacaine or a 0.05% lower concentration. Successful block was defined as pain &lt;4 during 6 h. Patients underwent general anesthesia with 30 µg/kg alfentanil and propofol and maintenance with propofol, and, if necessary, remifentanil was administered. Postoperative analgesia was complemented with dipyrone, and if necessary, tramadol (100 mg) could be used. The following parameters were assessed: the success of the block; pain intensity after 2, 4, and 6 h; the consumption of remifentanil; time to the first analgesic supplementation; percent of patients who needed analgesics during 6h; and muscle strength. The MEC50 of ropivacaine was 0.36%, and the MEC90 was 0.477%. The block was successful in 45 patients. 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subjects Alfentanil
Analgesics
Anesthesia
Blood pressure
Clinical Trial Report
Comparative analysis
Double-blind studies
Experiments
Knee
Pain
Patients
Probability
Remifentanil
Software
Surgery
Ultrasonic imaging
Variance analysis
Veins & arteries
title Minimum Effective Analgesic Concentration of Ropivacaine in Saphenous Block Guided by Ultrasound for Knee Arthroscopic Meniscectomy: Randomized, Double-Blind Study
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