The median effective concentration of ropivacaine for ultrasound-guided caudal block in children: a dose-finding study

作者全名："Tian, Yaqiong; Li, Shangyingying; Yang, Fei; Yang, Li; Liu, Ling; Gao, Wen; Tu, Shengfen"

作者地址："[Tian, Yaqiong; Li, Shangyingying; Yang, Fei; Yang, Li; Liu, Ling; Gao, Wen; Tu, Shengfen] Childrens Hosp Chongqing Med Univ, Natl Clin Res Ctr Child Hlth & Disorders, Dept Resp Med,Key Lab Child Dev & Disorders, Minist Educ, 136 Zhongshan 2nd Rd, Chongqing 400014, Peoples R China; [Liu, Ling; Gao, Wen; Tu, Shengfen] Chongqing Key Lab Pediat, Chongqing 400014, Peoples R China"

通信作者："Tu, SF (通讯作者)，Childrens Hosp Chongqing Med Univ, Natl Clin Res Ctr Child Hlth & Disorders, Dept Resp Med,Key Lab Child Dev & Disorders, Minist Educ, 136 Zhongshan 2nd Rd, Chongqing 400014, Peoples R China.; Tu, SF (通讯作者)，Chongqing Key Lab Pediat, Chongqing 400014, Peoples R China."

来源：JOURNAL OF ANESTHESIA

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001136771200001

JCR分区：Q2

影响因子：2.8

年份：2024

卷号：　

期号：　

开始页：　

结束页：　

文献类型：Article; Early Access

关键词：Caudal block; Ropivacaine; Child; Hypospadias; MEC50

摘要："Purpose To determine the 50% minimum effective concentration (MEC50) and the 95% effective concentration (MEC95) of ropivacaine for ultrasound-guided caudal block during hypospadias repair surgery of pediatric patients.Methods Children were enrolled with the American Society of Anesthesiologists (ASA) physical status I-II undergoing elective hypospadias repair surgery. Children were grouped into two age groups: toddlerhood (1-3 years old) and preschool (3-6 years old). We measured The MEC50 using Dixon's up-and-down method. The first children received the caudal block with 1.0 mL/kg of 0.15% ropivacaine. We determined each subsequent patient's concentration based on the previous patient's response and adjusted the concentration in intervals of 0.015%. Meanwhile, the probit regression analysis obtains 95% effective concentration (MEC95). In addition, we recorded the general condition, adverse events, and postoperative pain of each child.Results 46 children undergoing elective hypospadias repair surgery were included in this study, 22 in the toddlerhood group and 24 in the preschool group. Of the total number of patients, the caudal block was successful in 25 (54%) and failed in 21 (46%). The MEC50 of 1 ml/kg ropivacaine was 0.102% (95% CI 0.099%, 0.138%) in the toddlerhood group and 0.129% (95% CI 0.124%, 0.138%) in the preschool group. The MEC95 of 1 ml/kg ropivacaine was 0.148% (95% CI 0.131%, 0.149%) in the toddlerhood group and 0.162% (95% CI 0.134%, 0.164%) in the preschool group. Our results showed that ropivacaine concentration was statistically different between preschool children and toddlers (P < 0.001). None of the adverse events occurred.Conclusions This study showed that children in the preschool group required higher concentrations of ropivacaine than children in the toddler group during ultrasound-guided sacral block combined with non-intubated general anesthesia. At the same time, this method of anesthesia is safe and effective for children undergoing surgery for hypospadias."

基金机构：Urology Department at the Children's Hospital

基金资助正文："Assistance with the article: We would like to thank all staff from the Anesthesia Department and Urology Department at the Children's Hospital affiliated with Chongqing Medical University, China, for their help with this article."