Median effective dose of 0.2% ropivacaine for ultrasound-guided median nerve block in young children.

Abstract

OBJECTIVE:

To determine the median effective dose (ED50) and the 95% effective dose (ED95) of 0.2% ropivacaine for ultrasound-guided lower forearm median nerve block in paediatric patients.

METHODS:

Eligible children were American Society of Anesthesiologists (ASA) status I-II scheduled to have elective open surgery for trigger thumb repair. Patients were stratified into two age groups: 1- to 3-year-olds and 3- to 6-year-olds. The ED50 was determined by Dixon's up-and-down method. The first patient received an ultrasound-guided median nerve block by injection of 2 mL of 0.2% ropivacaine. Each subsequent patient's dose was determined by the response of the previous patient, the doses being adjusted in intervals of 0.2 mL. In addition, the 95% effective dose (ED95) was obtained using a probit regression approach. The patients' general condition, postoperative pain scores, and adverse events were recorded.

RESULTS:

A total of 52 children who were scheduled to undergo open surgery for trigger thumb were included in this study: 28 in the 1- to 3-year-olds group and 24 in the 3- to 6-year-olds group. The ED50 (95% confidence interval) values were 0.9 (0.44-1.36) mL in 1- to 3-year-olds and 1.4 (1.14-1.66) mL in 3- to 6-year-olds. The ED95 (95% confidence interval) values were 1.5 (0.98-1.58) mL in 1- to 3-year-olds and 1.7 (1.54-1.78) mL in 3- to 6-year-olds. No adverse events occurred.

CONCLUSIONS:

A single dose of ropivacaine was an effective agent for young children requiring ultrasound-guided lower forearm median nerve block in open surgery for trigger thumb. The ED50 (95% confidence interval) values were 0.9 (0.44-1.36) mL in 1- to 3-year-olds and 1.4 (1.14-1.66) mL in 3- to 6-year-olds. The ED95 (95% confidence interval) values were 1.5 (0.98-1.58) mL in 1- to 3-year-olds and 1.7 (1.54-1.78) mL in 3- to 6-year-olds.

• Authors: Weiping Wang, Hang Chen, Shangyingying Li, Wen Gao, Lin Bai, Hong Wang, Yuan Shi, Dazhen Li, Hongzhen Xu, Fei Yang, Shengfen Tu
• Journal: Anaesthesia, critical care & pain medicine (Anaesth Crit Care Pain Med) Vol. 42 Issue 1 Pg. 101159 (02 2023) ISSN: 2352-5568 [Electronic] France
• PMID: 36122851 (Publication Type: Journal Article)
• Copyright: Copyright © 2022. Published by Elsevier Masson SAS.

Chemical References

• Ropivacaine
• Anesthetics, Local
• Amides

Topics

• Humans
• Child
• Child, Preschool
• Infant
• Ropivacaine
• Anesthetics, Local
• Median Nerve
• Trigger Finger Disorder
• Amides
• Nerve Block
• Ultrasonography, Interventional