title: A randomised controlled comparison between stimulating and standard catheters for lumbar plexus block.
abstract: The aim of this randomised, prospective, blinded study was to evaluate if stimulating catheters can decrease the minimum effective anaesthetic volume in 50% of patients during lumbar plexus block using mepivacaine 1.5% compared with standard catheters. Fifty-eight patients of ASA physical status 1-3 were randomly allocated to receive a lumbar plexus block via a stimulating or standard catheter, with 29 in each group. The first dose was 30 ml and subsequent doses were determined using the up-and-down staircase method. The minimum effective anaesthetic volume50 was 12.2 ml (95% CI 7.3-17.1 ml) using the stimulating catheter and 24.8 ml (95% CI 23.2-27.5 ml) with the standard catheter (p < 0.0001). Complete lumbar plexus block was achieved with the initial dose of mepivacaine in 29 (100%) patients in the stimulating catheter group and 20 (69%) patients in the standard catheter group (p = 0.002). This study showed that use of a stimulating catheter halves the minimum effective anaesthetic volume50 of mepivacaine 1.5% while increasing the success rate in patients receiving continuous lumbar plexus block.
authors: Department of Anaesthesia, Istituto Ortopedico G. Pini, Milan, Italy.
authors: G
authors: G
authors: Cappelleri
authors: Department of Anaesthesia, Istituti Ospidalieri di Cremona, Cremona, Italy.
authors: D
authors: D
authors: Ghisi
authors: Department of Anaesthesia, Università degli studi di Milano, Milan, Italy.
authors: E
authors: E
authors: Ceravola
authors: Department of Anaesthesia, Università degli Studi Insubria di Varese, Varese, Italy.
authors: L
authors: L
authors: Guzzetti
authors: Department of Anaesthesia, Ospedale di Circolo Varese, Varese, Italy.
authors: A L
authors: AL
authors: Ambrosoli
authors: Department of Anaesthesia, IRCCS Ospedale San Raffaele, Milan, Italy.
authors: M
authors: M
authors: Gemma
authors: Department of Anaesthesia, Istituto Ortopedico G. Pini, Milan, Italy.
authors: G
authors: G
authors: Cornaggia
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000779:Anesthetics, Local / Q000008:administration & dosage; D057785:Catheters; D005260:Female; D006801:Humans; D008160:Lumbosacral Plexus; D008297:Male; D008619:Mepivacaine / Q000008:administration & dosage; D008875:Middle Aged; D009407:Nerve Block / Q000295:instrumentation*; D011446:Prospective Studies; D016037:Single-Blind Method
chemical_list: D000779:Anesthetics, Local; D008619:Mepivacaine