Minimum effective volume of 0.5 bupivacaine with epinephrine in ultrasound-guided interscalene brachial plexus block

Minimum effective volume of 0.5 bupivacaine with epinephrine in ultrasound-guided interscalene brachial plexus block

Author Falcão, Luiz Fernando dos Reis Autor UNIFESP Google Scholar
Perez, M. V. Autor UNIFESP Google Scholar
Castro, I. de Autor UNIFESP Google Scholar
Yamashita, A. M. Autor UNIFESP Google Scholar
Tardelli, M. A. Autor UNIFESP Google Scholar
Amaral, J. L. G. Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract The use of ultrasound (US) in regional anaesthesia enables a reduction in the local anaesthetic volume. the present study aimed to determine the minimum effective volume (MEV90) of 0.5 bupivacaine with epinephrine for interscalene brachial plexus block (ISBPB).The volume of the anaesthetic was determined using a step-up/step-down method and was based on the outcome of the preceding block. A positive or negative block resulted in a 1 ml reduction or increase in volume, respectively. the success of theblock was defined as the presence of motor block in three muscle groups and the absence of thermal and pain sensations in three dermatomes within 30 min of the injection. Diaphragmatic paralysis and analgesia were assessed at 30 min, 4, and 6 h.The MEV90 for US-guided brachial plexus block under the conditions of the present study was 0.95 ml [R-2: 0.97, 95 confidence interval (CI): 0.61.22 ml]. the estimated maximum volume that did not cause diaphragmatic block was 4.29 ml (R-2: 0.84, 95 CI: 3.564.98 ml). Effective postoperative analgesia was achieved with 2.34 ml (R-2: 0.87, 95 CI: 0.4811.47 ml).The MEV90 of 0.5 bupivacaine with epinephrine (1:200 000) for US-guided ISBPB was 0.95 ml. Adequate postoperative analgesia and a reduced incidence of diaphragmatic block can be obtained using from 2.34 to 4.29 ml.ClinicalTrials.gov. Registry NCT01244932.
Keywords anaesthetic
local
brachial plexus
bupivacaine
ultrasonography
Language English
Date 2013-03-01
Published in British Journal of Anaesthesia. Oxford: Oxford Univ Press, v. 110, n. 3, p. 450-455, 2013.
ISSN 0007-0912 (Sherpa/Romeo, impact factor)
Publisher Oxford Univ Press
Extent 450-455
Origin http://dx.doi.org/10.1093/bja/aes419
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000315123800018
URI http://repositorio.unifesp.br/handle/11600/36001

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