Minimal local anaesthetic volumes for sciatic nerve block: evaluation of ED99 in volunteers

Latzke, D.; Marhofer, Peter; Zeitlinger, Markus; Machata, A.-M.; Neumann, Friederike; Lackner, Edith; Kettner, Stephan C.

doi:10.1093/bja/aep368

Cited by 93 publications

(83 citation statements)

References 24 publications

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“…Our previous findings demonstrated that the ED 99 volume of LA was 0.10 ml.mm À2 sciatic nerve area in volunteers [2]. The present study was designed to translate these findings into clinical practice, and we have showed that the ED 99 volume is higher in patients undergoing surgery than in volunteers.…”

Section: Discussionmentioning

confidence: 50%

“…All volumes of LA were determined according to the nerve area measurement in mm 2 . The first sciatic nerve block was performed with 0.20 ml.mm À2 nerve area.…”

Section: à2mentioning

confidence: 99%

“…Several studies in volunteers have evaluated the effective dose (ED) of LA for peripheral regional blocks according to the cross-sectional nerve area to be blocked, and have shown that reduced volumes of LA are associated with similar block characteristics to conventional larger volumes. Eichenberger et al showed that the ulnar nerves at the proximal forearm can be effectively blocked with 0.7 ml (ED 95 = 0.11 ml.mm À2 cross-sectional nerve area) LA [1], and Latzke et al showed that sciatic nerve blocks can be performed with a median LA volume of 5.6 ml (ED 99 = 0.10 ml.mm À2 cross-sectional nerve area) [2].…”

Section: Introductionmentioning

confidence: 99%

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Effective local anaesthetic volumes for sciatic nerve blockade: a clinical evaluation of the ED₉₉

Keplinger

Marhofer

et al. 2015

Anaesthesia

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SummaryPrevious results in volunteers have indicated the effective dose in 99% of subjects (ED 99 ) of local anaesthetic volume to be 0.10 ml.mm À2 of cross-sectional nerve area for sciatic nerve blockade. The objective of this prospective, randomised, double-blind study was to investigate the ED 99 of local anaesthetic for ultrasound-guided sciatic nerve blockade in patients undergoing foot surgery, according to Dixon's up-and-down method and probit analysis. A starting volume of 0.20 ml local anaesthetic per mm 2 cross-sectional nerve area was used. If surgical anaesthesia was judged to be adequate, the volume of local anaesthetic for the next case was reduced by 0.02 ml.mm À2 , until the first block failed. Thereafter, the volume of local anaesthetic was increased by 0.02 ml.mm À2. The ED 99 volume of local anaesthetic for ultrasound-guided sciatic nerve blockade was calculated to be 0.15 ml.mm À2 cross-sectional nerve area, which is higher than the previously evaluated ED 99 volume in volunteers.

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Section: Discussionmentioning

confidence: 50%

“…All volumes of LA were determined according to the nerve area measurement in mm 2 . The first sciatic nerve block was performed with 0.20 ml.mm À2 nerve area.…”

Section: à2mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effective local anaesthetic volumes for sciatic nerve blockade: a clinical evaluation of the ED₉₉

Keplinger

Marhofer

et al. 2015

Anaesthesia

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“…To correlate our results with in vivo studies we reviewed ultrasound and MRI data from sciatic and sural nerves in healthy controls (Table 3). 9,16,23,26,42,44 These studies also demonstrate a large variability with regard to CSA, especially of the sural nerve. 9,15,16,26,44 Specifically, the sural nerve CSA as measured by ultrasound ranged from 1.44 to 5.3 mm 2 .…”

Section: Discussionmentioning

confidence: 64%

Challenges in sciatic nerve repair: anatomical considerations

Burks¹,

Levi²,

Hayes³

et al. 2014

JNS

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“…With the ultrasound to guide peripheral nerve block, the total volume of local anesthetic can be dramatically reduced so as to limit the risk of toxic side effects due to the drug. [3][4][5][6] The aim of this study is to determine the effectiveness of these two techniques, so that a more effective technique can be used for anesthesia superior extremity orthopedic surgery or can be used as an alternative option, and the authors believe that the particular regional anesthesia regional anesthesia is to minimize the inflammatory process that occurs as a result of actions surgery.…”

Section: Introductionmentioning

confidence: 99%

Regional Anesthesia Continuous Brachial Plexus Block With Ultrasonography Guidance

et al. 2015

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Background:Regional anesthesia has an anti-inflammatory effect that blockade the C-fiber hence reduced cytokine production and blocked the activity of the sympathetic nerve fibers. Postoperative pain caused primarily by tissue inflammation and activity of the C-fibers in the manner of reduced the production of cytokines, regional anesthesia may limit the inflammatory response after surgery and severity of postoperative pain. Methods: This study is a clinical experimental study with randomized pre and post test control group design. A total of 24 samples were recruited in this study divided into two groups each consisting of 12 samples. The first group was given regional anesthesia method of continuous brachial plexus block with ultrasound guidance and the second group with general anesthesia method. T-test or Mann-Whitney continued multivariate linear regression analysis was performed to analyze the differences in treatment and not because of differences in the initial values with significance level of p<0.05. Results: This study reports that the mean decreased levels of IL-6 postoperatively in 1 st group is 29.8 lower than in 2 nd group and it is statistically significant p< 0.05. There was an increase of IL-10 mean levels from preoperative to postoperatively with significance level of p<0.05 in both groups. Declined in the mean levels of PAF postoperatively in 1 st group 1.3 lower than 2 nd group and it was statistically significant p<0.05. The declined of postoperative VAS in 1 st group is 3.1 lower than 2 nd group and it is statistically significant p< 0.05, and it also contained the pure effect of PAF levels against value of VAS that any increased 1ng/ml levels of PAF then an increase in the value of 0.18 cm VAS and this was statistically significant p<0.05. Selection of this anesthesia technique in orthopedic antebrachii surgery provides better inflammatory response and improved clinical outcomes.

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Minimal local anaesthetic volumes for sciatic nerve block: evaluation of ED99 in volunteers

Cited by 93 publications

References 24 publications

Effective local anaesthetic volumes for sciatic nerve blockade: a clinical evaluation of the ED₉₉

Effective local anaesthetic volumes for sciatic nerve blockade: a clinical evaluation of the ED₉₉

Challenges in sciatic nerve repair: anatomical considerations

Regional Anesthesia Continuous Brachial Plexus Block With Ultrasonography Guidance

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Minimal local anaesthetic volumes for sciatic nerve block: evaluation of ED99 in volunteers

Cited by 93 publications

References 24 publications

Effective local anaesthetic volumes for sciatic nerve blockade: a clinical evaluation of the ED99

Effective local anaesthetic volumes for sciatic nerve blockade: a clinical evaluation of the ED99

Challenges in sciatic nerve repair: anatomical considerations

Regional Anesthesia Continuous Brachial Plexus Block With Ultrasonography Guidance

Contact Info

Product

Resources

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Effective local anaesthetic volumes for sciatic nerve blockade: a clinical evaluation of the ED₉₉

Effective local anaesthetic volumes for sciatic nerve blockade: a clinical evaluation of the ED₉₉