ED 50 and ED 95 of hypobaric ropivacaine during unilateral spinal anesthesia in older patients undergoing hip replacement surgery

Chao Lin^1,2Jun Xu¹Wen-Lin Xian¹Ting Zhao¹Zhi-Qiang Wu¹Fangjun Wang^1*

• ¹Department of Anesthesiology, Affiliated Hospital of Sichuan North Medical College, Nanchong, Anhui Province, China
• ²People's Hospital of Yilong County, Yilong, Sichuan, China

The spinal block was limited to the operative side during unilateral spinal anesthesia, which has less physiological interference and fewer complications for the patient. The optimal dose of ropivacaine for unilateral spinal anesthesia is still unclear.The aim of this trial was to investigate the ED50 and ED95 of hypobaric ropivacaine during unilateral spinal anesthesia in older patients undergoing hip arthroplasty.Methods: All patients were administered hypobaric ropivacaine at a spinal anesthetic drug concentration of 0.4%. The trial was conducted using the Dixon sequential method with an initial dose of 10 mg of ropivacaine and a dose difference of 0.5 mg between two consecutive patients. If the subject's post-block non-surgical leg Bromage score is greater than 0, the next subject's dose of ropivacaine is reduced by 0.5 mg. If the subject's post-block non-surgical leg Bromage score is equal to 0, the next patient's dose of ropivacaine is increased by 0.5 mg. The trial was terminated when alternating positive-negative results were obtained for 7 pairs of patients. ED50, ED95, and the corresponding 95% confidence intervals (CI) for unilateral spinal anesthesia with 0.4% hypobaric ropivacaine were calculated using probit regression analysis. Results:The ED50 and ED95 of hypobaric ropivacaine during unilateral spinal anesthesia in older patients undergoing hip arthroplasty were 11.13 mg (95% CI: 10.85-11.42 mg) and 10.30 mg (95% CI: 9.04-10.65 mg), respectively. The drug dosage was higher in the positive group than in the negative group. There was no differences in the onset of anesthesia, block plane of the affected side, the sensory and motor block time of affected side, and the incidences of low blood pressure, nausea and vomiting, chills, urinary retention between groups (P>0.05).The ED50 and ED95 of hypobaric ropivacaine during unilateral spinal anesthesia in older patients undergoing hip arthroplasty were 11.13 mg (95% CI: 10.85-11.42 mg) and 10.30 mg (95% CI: 9.04-10.65 mg), respectively. Unilateral spinal anesthesia limits the level of block to the operative side with less physiologically disruptive to the patient, more stable perioperative hemodynamics and fewer complications.