Minimum effective volume of ropivacaine for ultrasound-guided supra-inguinal fascia iliaca compartment block

Yamada, Kumiko; Inomata, Shinichi; Sasaki, Shigeyuki

doi:10.1038/s41598-020-79059-7

Cited by 23 publications

(23 citation statements)

References 24 publications

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“…Yamada et al . [ 24 ] studied the minimum effective volume of LA in S-FICB. They found that the EV50 and EV95 of 0.25% ropivacaine for S-FICB were 15.01 ml and 26.99 ml, respectively.…”

Section: Discussionmentioning

confidence: 99%

Comparison of supra-inguinal fascia iliaca versus pericapsular nerve block for ease of positioning during spinal anaesthesia

Jadon

Mohsin

Sahoo

et al. 2021

Indian Journal of Anaesthesia

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Background and Aims: Regional analgesic techniques such as supra-inguinal fascia-iliaca compartment block (S-FICB) and pericapsular nerve group (PENG) block have been found to be effective in providing good pain relief in hip-fracture patients. However, comparative studies between PENG and S-FICB are lacking. The aim of this study was to compare the analgesic efficacy of S-FICB and PENG block and assess their efficacy in optimal patient positioning for spinal anaesthesia. Methods: A prospective randomised double-blind study was conducted in 66 patients randomly divided to receive either S-FICB or PENG block under ultrasound guidance. Primary outcome measures were numerical rating scale (NRS) pain score at rest and on passive 15° limb lifting, 30 minutes after the block and ease of spinal positioning. The secondary outcome measures were NRS over 24 hours, amount of tramadol used (number of rescue doses), patients' satisfaction and block-related complications. The results were analysed using statistical software (MedCalc version 19.2.1). Continuous and categorical data were analysed using appropriate statistical analysis and P < 0.05 was considered significant. Results: Post-block, the NRS score decreased significantly in PENG and S-FICB groups at rest and movement ( P < 0.0001). The EOSP score was significantly better in PENG group ( P < 0.0001). First analgesic request and pain relief in the first 24-hour period were similar between the groups ( P = 0.524). Conclusion: PENG block provided better pain relief and ease of positing during SA in patients with fractured hip scheduled for hip surgery.

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“…Yamada et al . [ 24 ] studied the minimum effective volume of LA in S-FICB. They found that the EV50 and EV95 of 0.25% ropivacaine for S-FICB were 15.01 ml and 26.99 ml, respectively.…”

Section: Discussionmentioning

confidence: 99%

Comparison of supra-inguinal fascia iliaca versus pericapsular nerve block for ease of positioning during spinal anaesthesia

Jadon

Mohsin

Sahoo

et al. 2021

Indian Journal of Anaesthesia

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“…In a cadaver study, Kris Vermeylen et al reported that 40 mL of local anesthetic was required to stain the femoral, lateral femoral cutaneous, and obturator nerves in adult cadavers by supra-inguinal FICB [21]. The study by Kumiko et al showed that the EV95 of 0.25% ropivacaine in suprainguinal FICB for blocking all three nerves was 27.0 mL [22]. We used 30 mL of analgesic in our clinical trial and demonstrated that the supra-inguinal approach was superior to the classical approach when evaluating sensory block in the obturator and lateral femoral cutaneous nerves.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound-guided supra-inguinal fascia Iliaca compartment block for older adults admitted to the emergency department with hip fracture: a randomized controlled, double-blind clinical trial

et al. 2021

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Background Hip fracture is common in older adults, and can cause severe post-fracture pain. Fascia iliaca nerve block has consequently been used for preoperative analgesia. Methods We performed a randomized, controlled, double-blind clinical trial and recruited older patients with hip fractures. These patients were randomized into two groups and received ultrasound-guided fascia iliaca compartment block using either the supra-inguinal approach (group F) or the classical approach (group C). Heart rate, blood pressure, and resting and exercising visual analog scales were recorded before the procedure and at 30 min, and 6, 12, and 24 h after completion of the procedure. We recorded the duration of the procedure—as well as complications such as bleeding, hypotension, and intractable vomiting; the sleep duration in a 24 h period was also documented. Results A total of 38 patients completed the trial, and we observed no differences in the baseline characteristics or pre-procedural measurements between the two groups. Compared with the patients in group C, patients in group F exhibited significantly lower exercising VAS scores at 6 and 12 h after the procedure, faster heart rates at 6 and 24 h after the procedure, a longer procedural duration, and a longer sleep duration. There were no differences in the frequencies of complications between the two groups. The percentages of patients who took oral analgesics and the numbers of medications consumed were also not different between the two groups. Conclusions The supra-inguinal FICB provided effective analgesia and improved exercise tolerance compared with the classical approach. Trial registration The trial was registered at the Chinese Clinical Trial Registry (registration number: ChiCTR2100045644, registration date: 2021 April 20).

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“…These results are consistent with previous cadaveric and clinical reports. Yamada et al (2020) demonstrated that the 50 % and 95 % effective volume of 0.25 % ropivacaine for the USG-SFIB was 15 and 27 ml. The definition of a successful block in that study was a loss of sensation of the LFCN and FN sensory distribution.…”

Section: Discussionmentioning

confidence: 94%

Distribution of Various Volumes of Methylene Blue Injection in Suprainguinal Fascia Iliaca Block Under Ultrasound Guidance: A Cadaveric Study

et al. 2022

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The local anesthetic volume for a single-shot suprainguinal fascia iliaca block (SFIB) is a key factor of a block success because the courses of the three target nerves from the lumbar plexus (LP), the lateral femoral cutaneous nerve (LFCN), femoral nerve (FN), and obturator nerve (ON), at the inguinal area are isolated and within striking distance. Thus, this cadaveric study aims to demonstrate the distribution of dye staining on the LFCN, FN, ON, and LP following the ultrasound-guided SFIB using 15-50 ml of methylene blue. A total of 40 USG-SFIBs were performed on 20 fresh adult cadavers using 15, 20, 25, 30, 35, 40, 45, and 50 ml of methylene blue. After the injections, the pelvic and inguinal regions were dissected to directly visualize the dye stained on the LFCN, FN, ON, and LP. All FN and LFCN were stained heavily when the 15-50 ml of dye was injected. Higher volumes of dye (40-50 ml) spread more medially and stained on the ON and LP in 60 % of cases. To increase the possibility of dye spreading to all three target nerves and LP of the SFIB, a high volume (≥40 ml) of anesthetic is recommended. If only a blockade of the FN and LFCN is required, a low volume (15-25 ml) of anesthetic is sufficient.

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Minimum effective volume of ropivacaine for ultrasound-guided supra-inguinal fascia iliaca compartment block

Cited by 23 publications

References 24 publications

Comparison of supra-inguinal fascia iliaca versus pericapsular nerve block for ease of positioning during spinal anaesthesia

Comparison of supra-inguinal fascia iliaca versus pericapsular nerve block for ease of positioning during spinal anaesthesia

Ultrasound-guided supra-inguinal fascia Iliaca compartment block for older adults admitted to the emergency department with hip fracture: a randomized controlled, double-blind clinical trial

Distribution of Various Volumes of Methylene Blue Injection in Suprainguinal Fascia Iliaca Block Under Ultrasound Guidance: A Cadaveric Study

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