Maximum effective volume of 0.25% ropivacaine for preventing hemidiaphragmatic paralysis in 90% of patients undergoing shoulder arthroscopy: a biased coin up-and-down sequential allocation trial for ultrasound-guided superior trunk block.

ABSTRACT:

Background

Compared to interscalene block (ISB), the superior trunk block (STB) lowers the incidence of hemidiaphragmatic paralysis (HDP) without compromising analgesic efficacy, making it a valuable alternative. However, the lack of consensus on the optimal local anesthetic (LA) dose for STB limits its standardized clinical application. This study employed a dose-finding protocol to determine the maximum effective volume of 0.25% ropivacaine required to prevent HDP in 90% of patients (MEV90) undergoing shoulder arthroscopy with ultrasound-guided STB.

Methods

A biased coin design was used for volume assignment. All patients except the first one received a LA volume determined by the response observed in the immediately preceding participant. In case of "failure" (defined as

SUBMITTER: Wang K 

PROVIDER: S-EPMC12312237 | biostudies-literature | 2025 Jul

REPOSITORIES: biostudies-literature