TY - JOUR
T1 - Local Anesthetic Injection Speed and Common Peroneal Nerve Block Duration
T2 - A Randomized Controlled Trial in Healthy Volunteers
AU - Madsen, Mikkel Herold
AU - Christiansen, Claus B
AU - Rothe, Christian
AU - Andreasen, Asger M
AU - Lundstrøm, Lars H
AU - Lange, Kai H W
PY - 2018/7/1
Y1 - 2018/7/1
N2 - Background and Objectives: The speed of local anesthetic (LA) injections in peripheral regional anesthesia ranges from slow continuous infusions (3-12 mL/h) to rapid manual injections (>7500 mL/h). Optimizing injection speed could augment the spread of LA toward the targeted nerves and influence nerve block characteristics. The objective of this study was to investigate whether injection speed of a single dose of LA affects peripheral nerve block duration. Methods: After approval from the Danish Regional Scientific Ethics Committee, we enrolled 60 healthy adult volunteers. We used an ultrasound-guided catheter-based technique to perform a common peroneal nerve block. Participants were randomized to receive 4.0 mL of ropivacaine 0.2% with 1 of 5 injection speeds: 12, 60, 300, 600, or 1800 mL/h. Investigators and participants were blinded to group assignment and intervention. Primary outcome was duration of sensory nerve block defined by insensitivity toward cold. Secondary outcomes were duration of motor nerve block, time to onset of sensory nerve block, and grades of sensory and motor nerve block. Intergroup differences were tested by one-way analysis of variance. Results: We found no differences in sensory block duration between the 5 groups. Durations were median [range]: 11 [6-14], 12 [9-14], 10.5 [2-15], 11 [8-17], and 12 [9-18] hours, respectively (P = 0.294). In addition, we found no differences in secondary outcomes. Conclusions: Injection speed of LA in the range of 12 to 1800 mL/h did not affect common peroneal nerve block duration.
AB - Background and Objectives: The speed of local anesthetic (LA) injections in peripheral regional anesthesia ranges from slow continuous infusions (3-12 mL/h) to rapid manual injections (>7500 mL/h). Optimizing injection speed could augment the spread of LA toward the targeted nerves and influence nerve block characteristics. The objective of this study was to investigate whether injection speed of a single dose of LA affects peripheral nerve block duration. Methods: After approval from the Danish Regional Scientific Ethics Committee, we enrolled 60 healthy adult volunteers. We used an ultrasound-guided catheter-based technique to perform a common peroneal nerve block. Participants were randomized to receive 4.0 mL of ropivacaine 0.2% with 1 of 5 injection speeds: 12, 60, 300, 600, or 1800 mL/h. Investigators and participants were blinded to group assignment and intervention. Primary outcome was duration of sensory nerve block defined by insensitivity toward cold. Secondary outcomes were duration of motor nerve block, time to onset of sensory nerve block, and grades of sensory and motor nerve block. Intergroup differences were tested by one-way analysis of variance. Results: We found no differences in sensory block duration between the 5 groups. Durations were median [range]: 11 [6-14], 12 [9-14], 10.5 [2-15], 11 [8-17], and 12 [9-18] hours, respectively (P = 0.294). In addition, we found no differences in secondary outcomes. Conclusions: Injection speed of LA in the range of 12 to 1800 mL/h did not affect common peroneal nerve block duration.
KW - Adult
KW - Anesthetics, Local/administration & dosage
KW - Cold Temperature/adverse effects
KW - Double-Blind Method
KW - Female
KW - Healthy Volunteers
KW - Humans
KW - Injections
KW - Male
KW - Nerve Block/methods
KW - Peroneal Nerve/drug effects
KW - Proof of Concept Study
KW - Sensory Thresholds/drug effects
KW - Time Factors
KW - Young Adult
U2 - 10.1097/AAP.0000000000000759
DO - 10.1097/AAP.0000000000000759
M3 - Journal article
C2 - 29570501
SN - 1098-7339
VL - 43
SP - 467
EP - 473
JO - Regional Anesthesia and Pain Medicine
JF - Regional Anesthesia and Pain Medicine
IS - 5
ER -