Minimum effective volume of mepivacaine for ultrasound-guided supraclavicular block
BackgroundThe aim of this study was to estimate the minimum effective volume (MEV) of 1.5% mepivacaine for ultrasound-guided supraclavicular block by placing the needle near the lower trunk of brachial plexus and multiple injections.MethodsThirty patients undergoing forearm and hand surgery received...
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| Language: | English |
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Korean Society of Anesthesiologists
2013-07-01
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| Series: | Korean Journal of Anesthesiology |
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| Online Access: | http://ekja.org/upload/pdf/kjae-65-37.pdf |
| _version_ | 1819169955367616512 |
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| author | Jae Gyok Song Dae Geun Jeon Bong Jin Kang Kee Keun Park |
| author_facet | Jae Gyok Song Dae Geun Jeon Bong Jin Kang Kee Keun Park |
| author_sort | Jae Gyok Song |
| collection | DOAJ |
| description | BackgroundThe aim of this study was to estimate the minimum effective volume (MEV) of 1.5% mepivacaine for ultrasound-guided supraclavicular block by placing the needle near the lower trunk of brachial plexus and multiple injections.MethodsThirty patients undergoing forearm and hand surgery received ultrasound-guided supraclavicular block with 1.5% mepivacaine. The initial volume of local anesthetic injected was 24 ml, and local anesthetic volume for the next patient was determined by the response of the previous patient. The next patient received a 3 ml higher volume in the case of the failure of the previous case. If the previous block was successful, the next volume was 3 ml lower. MEV was estimated by the Dixon and Massey up and down method. MEV in 95, 90, and 50% of patients (MEV95, MEV90, and MEV50) were calculated using probit transformation and logistic regression.ResultsMEV95 of 1.5% mepivacaine was 17 ml (95% confidence interval [CI], 13-42 ml), MEV90 was 15 ml (95% CI, 12-34 ml), and MEV50 was 9 ml (95% CI, 4-12 ml). Twelve patients had a failed block. Three patients received general anesthesia. Nine patients could undergo surgery with sedation only. Only one patient showed hemi-diaphragmatic paresis.ConclusionsMEV95 was 17 ml, MEV90 was 15 ml, and MEV50 was 9 ml. However, needle location near the lower trunk of brachial plexus and multiple injections should be performed. |
| first_indexed | 2024-12-22T19:27:43Z |
| format | Article |
| id | doaj.art-0c22894fbf324bc0949d8ee27043fc42 |
| institution | Directory Open Access Journal |
| issn | 2005-6419 2005-7563 |
| language | English |
| last_indexed | 2024-12-22T19:27:43Z |
| publishDate | 2013-07-01 |
| publisher | Korean Society of Anesthesiologists |
| record_format | Article |
| series | Korean Journal of Anesthesiology |
| spelling | doaj.art-0c22894fbf324bc0949d8ee27043fc422022-12-21T18:15:12ZengKorean Society of AnesthesiologistsKorean Journal of Anesthesiology2005-64192005-75632013-07-01651374110.4097/kjae.2013.65.1.377686Minimum effective volume of mepivacaine for ultrasound-guided supraclavicular blockJae Gyok Song0Dae Geun Jeon1Bong Jin Kang2Kee Keun Park3Department of Anesthesiology and Pain Medicine, College of Medicine, Dankook University, Cheonan, Korea.Department of Anesthesiology and Pain Medicine, College of Medicine, Dankook University, Cheonan, Korea.Department of Anesthesiology and Pain Medicine, College of Medicine, Dankook University, Cheonan, Korea.Department of Anesthesiology and Pain Medicine, College of Medicine, Dankook University, Cheonan, Korea.BackgroundThe aim of this study was to estimate the minimum effective volume (MEV) of 1.5% mepivacaine for ultrasound-guided supraclavicular block by placing the needle near the lower trunk of brachial plexus and multiple injections.MethodsThirty patients undergoing forearm and hand surgery received ultrasound-guided supraclavicular block with 1.5% mepivacaine. The initial volume of local anesthetic injected was 24 ml, and local anesthetic volume for the next patient was determined by the response of the previous patient. The next patient received a 3 ml higher volume in the case of the failure of the previous case. If the previous block was successful, the next volume was 3 ml lower. MEV was estimated by the Dixon and Massey up and down method. MEV in 95, 90, and 50% of patients (MEV95, MEV90, and MEV50) were calculated using probit transformation and logistic regression.ResultsMEV95 of 1.5% mepivacaine was 17 ml (95% confidence interval [CI], 13-42 ml), MEV90 was 15 ml (95% CI, 12-34 ml), and MEV50 was 9 ml (95% CI, 4-12 ml). Twelve patients had a failed block. Three patients received general anesthesia. Nine patients could undergo surgery with sedation only. Only one patient showed hemi-diaphragmatic paresis.ConclusionsMEV95 was 17 ml, MEV90 was 15 ml, and MEV50 was 9 ml. However, needle location near the lower trunk of brachial plexus and multiple injections should be performed.http://ekja.org/upload/pdf/kjae-65-37.pdfmepivacaineminimum effective volumesupraclavicular blockultrasound |
| spellingShingle | Jae Gyok Song Dae Geun Jeon Bong Jin Kang Kee Keun Park Minimum effective volume of mepivacaine for ultrasound-guided supraclavicular block Korean Journal of Anesthesiology mepivacaine minimum effective volume supraclavicular block ultrasound |
| title | Minimum effective volume of mepivacaine for ultrasound-guided supraclavicular block |
| title_full | Minimum effective volume of mepivacaine for ultrasound-guided supraclavicular block |
| title_fullStr | Minimum effective volume of mepivacaine for ultrasound-guided supraclavicular block |
| title_full_unstemmed | Minimum effective volume of mepivacaine for ultrasound-guided supraclavicular block |
| title_short | Minimum effective volume of mepivacaine for ultrasound-guided supraclavicular block |
| title_sort | minimum effective volume of mepivacaine for ultrasound guided supraclavicular block |
| topic | mepivacaine minimum effective volume supraclavicular block ultrasound |
| url | http://ekja.org/upload/pdf/kjae-65-37.pdf |
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