| Title |
Optimal dose of intrathecal isobaric bupivacaine in total knee arthroplasty
|
|---|---|
| Published in |
Canadian Journal of Anesthesia/Journal canadien d'anesthésie, 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. |
X Demographics
The data shown below were collected from the profiles of 23 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Spain | 4 | 17% |
| Canada | 4 | 17% |
| United Kingdom | 2 | 9% |
| United States | 2 | 9% |
| Mexico | 1 | 4% |
| Turkey | 1 | 4% |
| France | 1 | 4% |
| Ireland | 1 | 4% |
| Austria | 1 | 4% |
| Other | 0 | 0% |
| Unknown | 6 | 26% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 19 | 83% |
| Science communicators (journalists, bloggers, editors) | 2 | 9% |
| Practitioners (doctors, other healthcare professionals) | 2 | 9% |
Mendeley readers
The data shown below were compiled from readership statistics for 31 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 31 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 4 | 13% |
| Student > Bachelor | 3 | 10% |
| Student > Doctoral Student | 3 | 10% |
| Researcher | 3 | 10% |
| Other | 1 | 3% |
| Other | 4 | 13% |
| Unknown | 13 | 42% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 12 | 39% |
| Nursing and Health Professions | 4 | 13% |
| Economics, Econometrics and Finance | 1 | 3% |
| Computer Science | 1 | 3% |
| Unknown | 13 | 42% |
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 11 September 2020.
All research outputs
#2,435,197
of 25,382,440 outputs
Outputs from Canadian Journal of Anesthesia/Journal canadien d'anesthésie
#367
of 2,879 outputs
Outputs of similar age
#49,025
of 342,877 outputs
Outputs of similar age from Canadian Journal of Anesthesia/Journal canadien d'anesthésie
#10
of 46 outputs
Altmetric has tracked 25,382,440 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 90th percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 2,879 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 9.6. This one has done well, scoring higher than 87% 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 342,877 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 85% of its contemporaries.
We're also able to compare this research output to 46 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 76% of its contemporaries.