Minimum effective anaesthetic volume of 0.5% ropivacaine for ultrasound-guided popliteal sciatic nerve block in patients undergoing foot and ankle surgery: determination of ED50 and ED95.

Abstract

Compared to nerve stimulation or classic paraesthesia techniques, ultrasound (US)-guided popliteal sciatic nerve block requires a smaller volume of local anaesthetic. The up-and-down method was used to determine the minimum effective anaesthetic volume of 0.5% ropivacaine necessary for US-guided popliteal sciatic nerve block to achieve successful surgical anaesthesia for foot and ankle surgery. The study included 32 patients receiving an US-guided popliteal sciatic nerve bock. The starting dose of 0.5% ropivacaine was set at 30 ml, which was decreased by 3 ml if the block succeeded and increased by 3 ml if the block failed. After the injection of local anaesthetic, the degree of sensory and motor blockade of the tibial and common peroneal nerves was assessed every 5 minutes for 30 minutes. The ED50 and ED95 volumes of local anaesthetic were 6 ml and 16 ml, respectively. The success rates of sensory blockade of the tibial nerve and common peroneal nerve were 69% and 88%, respectively. The success rates of motor blockade of these nerves were 75% and 90%, respectively. The ED50 and ED95 of 0.5% ropivacaine for US-guided popliteal sciatic nerve block were 6 ml and 16 ml, respectively.