95% effective volume of ropivacaine for ultrasound‑guided supra‑inguinal fascia iliaca compartment block

Abstract

BackgroundHip arthroplasty is effective in treating hip diseases, such as osteoarthritis and hip fracture, but it often brings severe trauma and pain. In recent years, ultrasound-guided supra-inguinal fascia iliaca compartment block(S-FICB) has become a widely used nerve block method for analgesia in hip arthroplasty.MethodsFifty-three patients preparing for hip arthroplasty were prospectively enrolled. S-FICB was performed under ultrasound guidance, and inject 0.33% ropivacaine into the space. Using the biased-coin design (BCD) sequential allocation method. The initial volume of 0.33% ropivacaine was 30ml. In case of failure, the next patient received a higher volume (defined as the previous volume with an increment of 1.2 mL). If the previous patient had a successful block, the next patient was randomized to a lower volume (defined as the previous volume with a decrement of 1.2 mL), with a probability of b = 0.05, or the same volume, with a probability of 1 − b = 0.95. The study was stopped when 45 successful blocks were achieved.ResultsForty-five patients (84.9%) were blocked successfully. The 95% effective volume (EV95) was 34.06ml (95%CI 33.35 ~ 36.28ml). There were 31 patients with non-fracture in this study. The quadriceps muscle strength decreased in only two patients. Moreover, they both received 34.8ml of ropivacaine for S-FICB. Twenty-two patients had hip fractures. There were 3 patients (14%) with failed blocks and 19 patients (86%) with successful blocks. However, all fracture patients experienced less pain after S-FICB.ConclusionEV95 of 0.33% ropivacaine for ultrasound-guided S-FICB was 34.06ml.Trial registrationThe trial was registered at the Chinese Clinical Trial Registry (registration number: ChiCTR2100052214, registration date: 2021 October 22).