Importance of Volume and Concentration for Ropivacaine Interscalene Block in Preventing Recovery Room Pain and Minimizing Motor Block after Shoulder Surgery

@article{Fredrickson2010ImportanceOV,
  title={Importance of Volume and Concentration for Ropivacaine Interscalene Block in Preventing Recovery Room Pain and Minimizing Motor Block after Shoulder Surgery},
  author={Michael J. Fredrickson and Katherine R. Smith and Arnold Wong},
  journal={Anesthesiology},
  year={2010},
  volume={112},
  pages={1374-1381}
}
BACKGROUND This three-staged study estimated the volume and concentration of interscalene ropivacaine that would prevent recovery room pain after shoulder surgery under general anesthesia. [] Key Method Stage 3: Subjects were randomly assigned to receive 30 ml of ropivacaine, 0.5% ("conventional dose"), or 20 ml of ropivacaine, 0.375% (the estimated ED(volume+concentration)95 from stages 1/2). A postoperative elastomeric infusion of 0.2% ropivacaine (2 ml/h) was administered.
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Effective background infusion rate of ropivacaine 0.2% for patient‐controlled interscalene brachial plexus analgesia after rotator cuff repair surgery
TLDR
The effective background rate for patient‐controlled interscalene brachial plexus analgesia after shoulder surgery in 50% and 95% of the patients was 2.8 and 4.4 ml/h, respectively.
Comparison between two different concentrations of a fixed dose of ropivacaine in interscalene brachial plexus block for pain management after arthroscopic shoulder surgery: a randomized clinical trial
TLDR
Compared with 10 ml of0.75% ropivacaine, interscalene block with 20 ml of 0.375% roPivacane could be effective for the reduction of postoperative opioid requirement within 24 h after surgery despite it might not prolong the analgesic duration.
Comparison of Two Different Volumes of Ropivacaine Used in Nerve Stimulator Guided Inter-scalene Block for Arthroscopic Shoulder Surgery – A Randomized Controlled Trial
TLDR
Comparing the analgesic efficacy of 10 ml versus 20 mL of 0.5% ropivacaine in nerve stimulator guided interscalene brachial plexus block in patients undergoing arthroscopic shoulder surgery revealed a difference in the total postoperative fentanyl consumption over 24 h, which was significantly higher in Group B than Group A.
Dose-response studies of Ropivacaine in blood flow of upper extremity after supraclavicular block: a double-blind randomized controlled study
TLDR
The dose-response curve between SB ropivacaine and the changes of BF was determined and it was found that the maximal sympathetic block needs higher concentration than that complete sensation block needs which may benefit for microvascular surgery.
Volume of ropivacaine 0.2% and common peroneal nerve block duration: a randomised, double‐blind cohort trial in healthy volunteers
TLDR
There is a ceiling effect of increasing volume of ropivacaine 0.2% on both sensory and motor block duration of the common peroneal nerve, and there is no effect on nerve block duration (10 ml for sensory block and 15 ml for motor block).
Effect of local anesthetic volume (20 mL vs 30 mL ropivacaine) on electromyography of the diaphragm and pulmonary function after ultrasound-guided supraclavicular brachial plexus block: a randomized controlled trial
TLDR
The incidence rates of phrenic nerve palsy and diaphragm paralysis were reduced, and lung function was less impaired in patients who received 20 mL vs 30 mL of 0.375% ropivacaine without any differences in block success.
A Dose-Ranging Study of 0.5% Bupivacaine or Ropivacaine on the Success and Duration of the Ultrasound-Guided, Nerve-Stimulator–Assisted Sciatic Nerve Block: A Double-Blind, Randomized Clinical Trial
TLDR
Injection volumes of 2.5 and 5 mL were associated with delayed onset and decreased block duration and a greater fraction of subjects experiencing pain behind the knee and the effect of various volumes injected beneath the CIEL on the success and duration of sciatic nerve block was examined.
Randomized Study of the Effect of Local Anesthetic Volume and Concentration on the Duration of Peripheral Nerve Blockade
TLDR
Block duration is influenced by both local anesthetic volume and concentration, a finding of increasing relevance with the current trend to lower volumes for ultrasound-guided regional anesthesia.
Effect of Ultrasound-guided Nerve Block With 0.75% Ropivacaine at the Mid-forearm on the Prevalence of Moderate to Severe Pain After Hand Surgery.
The Ropivacaine Concentration Required for Ultrasound-Guided Ilioinguinal/Iliohypogastric Nerve Block in Pediatric Patients
TLDR
The EC50 of ropivacaine for ultrasound-guided INB was 0.21% (95% confidence interval, 0.03–0.34), in pediatric patients anesthetized with 2% sevoflurane in children anesthetics with unilateral open inguinal hernia repair.
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