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Minimum local anesthetic volumes for a selective saphenous nerve block: a dose-finding study
Werner Ten Hoope1, Markus W Hollmann2, Arthur Atchabahian3
1Department of Anesthesiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Minerva Anestesiologica
|November 12, 2016
Summary
Determining the minimum local anesthetic volume (MLAV) for ultrasound-guided saphenous nerve blocks is crucial for effective pain relief. The study found that 1.9 mL of mepivacaine 2% achieves a 95% success rate (ED95) for this block.
Area of Science:
- Anesthesiology
- Regional Anesthesia
- Ultrasound-Guided Procedures
Background:
- Saphenous nerve block is vital for analgesia in knee and lower leg surgeries.
- Current literature shows significant variability in local anesthetic volumes used for this block.
Purpose of the Study:
- To determine the minimum local anesthetic volume (MLAV) of mepivacaine 2% for a selective ultrasound-guided saphenous nerve block.
- To establish the effective dose 50 (ED50) and effective dose 95 (ED95) for this block.
Main Methods:
- A non-randomized controlled trial involving 18 healthy volunteers.
- Utilized the Dixon up-and-down method to determine MLAV.
- Assessed block onset, duration, cutaneous spread, and potential femoral nerve motor block.
Main Results:
- The ED50 for a complete saphenous nerve block was 1.5 mL; the ED95 was 1.9 mL.
- The saphenous nerve was consistently located anteromedially to the femoral artery.
- No correlation was found between anesthetic volume and block onset or duration; no femoral motor block occurred.
Conclusions:
- The effective dose 95 (ED95) for the minimum local anesthetic volume (MLAV) of mepivacaine 2% for an ultrasound-guided saphenous nerve block is 1.9 mL.
- This volume ensures a high success rate for selective saphenous nerve blockade.
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