ArticleFrontiers in medicine2022
Median Effective Analgesic Concentration of Ropivacaine in Ultrasound-Guided Interscalene Brachial Plexus Block as a Postoperative Analgesia for Proximal Humerus Fracture: A Prospective Double-Blind Up-Down Concentration-Finding Study.
Article in Frontiers in medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed, 7 citations in OpenAlex.
- Regional anesthesia strategies for proximal humerus fracture surgery: anatomical considerations, diaphragm-sparing techniques, and expert perspectives-a narrative review.Langenbeck's archives of surgery · 2026Review
- A randomized double-blinded study assessing the effect of different doses of transnasal dexmedetomidine on the median effective concentration of ropivacaine for a caudal block.Frontiers in medicine · 2024Article
- Effects of dexmedetomidine-ropivacaine assisted combined spinal-epidural anesthesia on neutrophil-lymphocyte ratio and postoperative delirium in elderly patients with intertrochanteric femoral fracture.Frontiers in pharmacology · 2024Article
- Modified Dixon sequential method to determine the effective dose of alfentanil compounded with propofol for day-case hysteroscopy.Therapeutic advances in drug safety · 2023Article
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: The innervation of the proximal humerus fracture is complicated and unclear. The use of interscalene nerve block has been effective as postoperative analgesia for patients, but the optimal concentration of usage is unknown. Method: This study was conducted on 30 patients with ASA I or II, who were planning to undergo a proximal humerus fracture operation. A dosage of 10 ml Ropivacaine was administered for the interscalene brachial plexus block (ISBPB) as determined using the up-and-down sequential method. The initial concentration of Ropivacaine in the first patient to receive ISBPB was 0.3%. After a successful or unsuccessful postoperative analgesia, the concentration of local anesthetic was decreased or increased, respectively, by 0.05% in the next patient. We defined successful postoperative analgesia as a visual analog scale (VAS) 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 to determine the EC50 of Ropivacaine, and the residual standard errors were calculated for the comparison of "goodness of fit." Results: The concentration of Ropivacaine ranged from 0.1 to 0.35%. The EC50 (95% confidence interval) from 4 different statistical approaches (linear, linear-logarithmic, exponential regressions, and centered isotonic regression) were 0.222% (0.198%, 0.335%), 0.233% (0.215%, 0.453%), 0.223% (0.202%, 0.436%), and 0.232%, respectively. Among all the 4 models, the linear regression had the least residual standard error (0.1676). Conclusion: The EC50 from the four statistical models for 10 ml Ropivacaine in ultrasound-guided ISBPB for postoperative analgesia was distributed in a narrow range of 0.222-0.233%. Trial Registration: www.chictr.org.cn/; registration number: ChiCTR2100047231.
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