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Increasing the injection volume by dilution improves the onset of motor blockade, but not sensory blockade of ropivacaine for brachial plexus block

Published online by Cambridge University Press:  02 June 2005

H. Krenn ,
E. Deusch ,
B. Balogh ,
H. Jellinek ,
W. Oczenski ,
E. Plainer-Zöchling  and
R. D. Fitzgerald
H. Krenn
Affiliation:
Department of Anaesthesia and Critical Care, City Hospital, Lainz, Vienna, Austria
E. Deusch
Affiliation:
Department of Anaesthesia and Critical Care, City Hospital, Lainz, Vienna, Austria Department of Anaesthesia and Critical Care, General Hospital, Vienna, Austria
B. Balogh
Affiliation:
Ludwig Boltzmann Institute for Quality Assurance in Plastic and Reconstructive Surgery, Innsbruck, Austria Department of Plastic and Reconstructive Surgery, City Hospital, Lainz, Vienna, Austria
H. Jellinek
Affiliation:
Department of Anaesthesia and Critical Care, City Hospital, Lainz, Vienna, Austria
W. Oczenski
Affiliation:
Department of Anaesthesia and Critical Care, City Hospital, Lainz, Vienna, Austria
E. Plainer-Zöchling
Affiliation:
Department of Anaesthesia and Critical Care, City Hospital, Lainz, Vienna, Austria
R. D. Fitzgerald
Affiliation:
Department of Anaesthesia and Critical Care, City Hospital, Lainz, Vienna, Austria Ludwig Boltzmann Institute for Economy in Anaesthesia and Critical Care, City Hospital, Lainz, Vienna, Austria
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Extract

Summary

Background and objective: Ropivacaine used for axillary plexus block provides effective motor and sensory blockade. Varying clinical dosage recommendations exist. Increasing the dosage by increasing the concentration showed no improvement in onset. We compared the behaviour of a constant dose of ropivacaine 150 mg diluted in a 30, 40 or 60 mL injection volume for axillary (brachial) plexus block.

Methods: A prospective, randomized, observer-blinded study on patients undergoing elective hand surgery was conducted in a community hospital. Three groups of patients with a constant dose of ropivacaine 150 mg, diluted in 30, 40 or 60 mL NaCl 0.9%, for axillary plexus blockade were compared for onset times of motor and sensory block onset by assessing muscle strength, two-point discrimination and constant-touch sensation.

Results: Increasing the injection volume of ropivacaine 150 mg to 60 mL led to a faster onset of motor block, but not of sensory block, in axillary plexus block, compared with 30 or 40 mL volumes of injection.

Conclusions: The data show that the onset of motor, but not of sensory block, is accelerated by increasing the injection volume to 60 mL using ropivacaine 150 mg for axillary plexus block. This may be useful for a more rapid determination of whether the brachial plexus block is effective. However, when performing surgery in the area of the block, sensory block onset seems more important.

Keywords

ANAESTHESIA CONDUCTION, anaesthesia, localSPINAL NERVES, brachial plexusANAESTHETICS, LOCAL, ropivacaine
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 20 , Issue 1 , January 2003 , pp. 21 - 25
Copyright
© 2003 European Society of Anaesthesiology

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