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Perineural Dexmedetomidine as an Adjuvant Reduces the Median Effective Concentration of Lidocaine for Obturator Nerve Blocking: A Double-Blinded Randomized Controlled Trial.

Lu Y, Sun J, Zhuang X, Lv G, Li Y, Wang H, Wang G - PLoS ONE (2016)

Bottom Line: We hypothesized that adding dexmedetomidine as an adjuvant to an obturator nerve block could reduce the median effective concentration of lidocaine.The median effective concentration of lidocaine was significantly lower in the D group than in the C group (p < 0.05).These results indicate that dexmedetomidine (1 μg/kg) in combination with lidocaine for obturator nerve block decreases the median effective concentration of lidocaine.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology, Second Hospital of Tianjin Medical University, Tianjin, China.

ABSTRACT

Unlabelled: Research suggests that the addition of dexmedetomidine to local anesthetics can prolong peripheral nerve blocks; however, it is not known whether dexmedetomidine can reduce the quantity of local anesthetic needed. We hypothesized that adding dexmedetomidine as an adjuvant to an obturator nerve block could reduce the median effective concentration of lidocaine. In this double-blinded randomized trial, 60 patients scheduled for elective transurethral resection of bladder tumors on the lateral wall were randomly divided into two groups: the control group (C group, n = 30) and the dexmedetomidine group (D group, n = 30). Two main branches of the obturator nerve (i.e., anterior and posterior) were identified using neural stimulation at the inguinal level, with only lidocaine used for the C group and 1 μg/kg dexmedetomidine combined with lidocaine used for the D group. The median effective concentration was determined by an up-and-down sequential trial. The ratio of two consecutive concentrations was 1.2. The median effective concentration (95% confidence interval) of lidocaine was 0.57% (0.54%-0.62%) in the C group and 0.29% (0.28%-0.38%) in the D group. The median effective concentration of lidocaine was significantly lower in the D group than in the C group (p < 0.05). These results indicate that dexmedetomidine (1 μg/kg) in combination with lidocaine for obturator nerve block decreases the median effective concentration of lidocaine.

Trial registration: ClinicalTrials.gov NCT02066727.

No MeSH data available.


Dose-response data of consecutive patients for both groups.The sequences of positive responses (solid dots) and negative responses (hollow dots) recorded in consecutive patients (A) for the C group and (B) for the D group.
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pone.0158226.g002: Dose-response data of consecutive patients for both groups.The sequences of positive responses (solid dots) and negative responses (hollow dots) recorded in consecutive patients (A) for the C group and (B) for the D group.

Mentions: The sequences of positive and negative responses recorded in consecutive patients for both groups are shown in Fig 2A and 2B. To provide better precision and narrow CIs for the point estimates, isotonic regression estimation and the PAVA approach were used. Nerve block failed when lidocaine was decreased to 0.50% in the C group and 0.29% in the D group, which were used as the first case for calculation. The EC50 of lidocaine required for ONB was 0.57% (95% CI, 0.54%-0.62%) in the C group, which is higher than that for D group [0.29% (95% CI, 0.28%-0.38%); p < 0.001] (Fig 3A and 3B).


Perineural Dexmedetomidine as an Adjuvant Reduces the Median Effective Concentration of Lidocaine for Obturator Nerve Blocking: A Double-Blinded Randomized Controlled Trial.

Lu Y, Sun J, Zhuang X, Lv G, Li Y, Wang H, Wang G - PLoS ONE (2016)

Dose-response data of consecutive patients for both groups.The sequences of positive responses (solid dots) and negative responses (hollow dots) recorded in consecutive patients (A) for the C group and (B) for the D group.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4920423&req=5

pone.0158226.g002: Dose-response data of consecutive patients for both groups.The sequences of positive responses (solid dots) and negative responses (hollow dots) recorded in consecutive patients (A) for the C group and (B) for the D group.
Mentions: The sequences of positive and negative responses recorded in consecutive patients for both groups are shown in Fig 2A and 2B. To provide better precision and narrow CIs for the point estimates, isotonic regression estimation and the PAVA approach were used. Nerve block failed when lidocaine was decreased to 0.50% in the C group and 0.29% in the D group, which were used as the first case for calculation. The EC50 of lidocaine required for ONB was 0.57% (95% CI, 0.54%-0.62%) in the C group, which is higher than that for D group [0.29% (95% CI, 0.28%-0.38%); p < 0.001] (Fig 3A and 3B).

Bottom Line: We hypothesized that adding dexmedetomidine as an adjuvant to an obturator nerve block could reduce the median effective concentration of lidocaine.The median effective concentration of lidocaine was significantly lower in the D group than in the C group (p < 0.05).These results indicate that dexmedetomidine (1 μg/kg) in combination with lidocaine for obturator nerve block decreases the median effective concentration of lidocaine.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology, Second Hospital of Tianjin Medical University, Tianjin, China.

ABSTRACT

Unlabelled: Research suggests that the addition of dexmedetomidine to local anesthetics can prolong peripheral nerve blocks; however, it is not known whether dexmedetomidine can reduce the quantity of local anesthetic needed. We hypothesized that adding dexmedetomidine as an adjuvant to an obturator nerve block could reduce the median effective concentration of lidocaine. In this double-blinded randomized trial, 60 patients scheduled for elective transurethral resection of bladder tumors on the lateral wall were randomly divided into two groups: the control group (C group, n = 30) and the dexmedetomidine group (D group, n = 30). Two main branches of the obturator nerve (i.e., anterior and posterior) were identified using neural stimulation at the inguinal level, with only lidocaine used for the C group and 1 μg/kg dexmedetomidine combined with lidocaine used for the D group. The median effective concentration was determined by an up-and-down sequential trial. The ratio of two consecutive concentrations was 1.2. The median effective concentration (95% confidence interval) of lidocaine was 0.57% (0.54%-0.62%) in the C group and 0.29% (0.28%-0.38%) in the D group. The median effective concentration of lidocaine was significantly lower in the D group than in the C group (p < 0.05). These results indicate that dexmedetomidine (1 μg/kg) in combination with lidocaine for obturator nerve block decreases the median effective concentration of lidocaine.

Trial registration: ClinicalTrials.gov NCT02066727.

No MeSH data available.