↓ Skip to main content

Optimal dose of intrathecal isobaric bupivacaine in total knee arthroplasty

Overview of attention for article published in Canadian Journal of Anesthesia, June 2018
Altmetric Badge

About this Attention Score

  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (86th percentile)
  • Good Attention Score compared to outputs of the same age and source (66th percentile)

Mentioned by

twitter
25 tweeters

Readers on

mendeley
7 Mendeley
Title
Optimal dose of intrathecal isobaric bupivacaine in total knee arthroplasty
Published in
Canadian Journal of Anesthesia, June 2018
DOI 10.1007/s12630-018-1165-4
Pubmed ID
Authors

Jeroen C. van Egmond, Hennie Verburg, Eveline A. Derks, Pim N. J. Langendijk, Caner Içli, Nick T. van Dasselaar, Nina M. C. Mathijssen

Abstract

Early mobilization is an important aspect of fast-track protocols and intrathecal bupivacaine is often used in primary total knee arthroplasty (TKA). Although the optimal dose is not known, conventional doses leave patients unable to mobilize for two to four hours. The dose of an intrathecally administered local anesthetic should therefore be optimized to achieve immediate postoperative mobilization. This study determined the median effective dose (ED) of intrathecal bupivacaine for primary unilateral TKA. Between April 2016 and February 2017 all patients who qualified for unilateral primary TKA were eligible for inclusion. In this dose-finding study, the up-and-down method by Dixon and Massey was used, which is a sequential allocation model. Patients received a dose of isobaric bupivacaine according to the outcome of the preceding patient with an initial starting dose of 5 mg. The dose was increased or decreased by steps of 0.5 mg, depending on the outcome of the preceding patient. During surgery, patients were closely monitored for indications of pain. Time points of regaining motor and sensory functions were determined. Twenty-five patients were included. Mean (SD) age was 70.1 (8.8) yr old, median [IQR] body mass index was 29.5 [27.3-30.9 kg·m-2], and 48% were female. In 11 patients the dose was inadequate; of these, nine patients needed additional anesthesia during surgery, and in four of these nine patients a conversion to general anesthesia was required. The median ED was 3.5 (95% confidence interval [CI], 3.1 to 4.0) mg of intrathecal bupivacaine. The calculated ED50 was 3.4 (95% CI, 2.7 to 4.0) mg; the calculated ED95 was 5 (95% CI, 3.7 to 8.0) mg. In this small study with tight control over operative duration, the median effective dosage of intrathecal isobaric bupivacaine for primary unilateral TKA was 3.5 mg and the ED95 was 5 mg. Reduction of conventional dosages of intrathecal bupivacaine is feasible at centres using fast-track arthroplasty protocols.

Twitter Demographics

The data shown below were collected from the profiles of 25 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 7 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 7 100%

Demographic breakdown

Readers by professional status Count As %
Student > Bachelor 2 29%
Unspecified 2 29%
Student > Master 1 14%
Librarian 1 14%
Student > Postgraduate 1 14%
Other 0 0%
Readers by discipline Count As %
Unspecified 3 43%
Medicine and Dentistry 2 29%
Computer Science 1 14%
Nursing and Health Professions 1 14%

Attention Score in Context

This research output has an Altmetric Attention Score of 15. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 24 February 2019.
All research outputs
#1,063,291
of 13,588,841 outputs
Outputs from Canadian Journal of Anesthesia
#173
of 1,687 outputs
Outputs of similar age
#30,918
of 227,537 outputs
Outputs of similar age from Canadian Journal of Anesthesia
#7
of 21 outputs
Altmetric has tracked 13,588,841 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 92nd percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 1,687 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 7.0. This one has done well, scoring higher than 89% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 227,537 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 86% of its contemporaries.
We're also able to compare this research output to 21 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 66% of its contemporaries.