Preoperative posterior quadratus lumborum block: determining the minimum effective ropivacaine concentration in 90% of patients (minimum effective concentration (MEC90)) for postoperative analgesia after laparoscopic myomectomy
Authors' conclusion
The optimal concentration of ropivacaine for posterior QLB to achieve satisfactory analgesia following laparoscopic myomectomy is a 20 mL volume of 0.340% ropivacaine per side.
Study context
- Population
- Women scheduled for elective laparoscopic myomectomy under GA45 successful blocks
- Participants
- 54 women
- Comparison
- Bilateral posterior quadratus lumborum block (QLB) with 20 mL ropivacaine per side at varying concentrations (biased coin design)
- Outcome
- MEC90 of ropivacaine for posterior QLB (block success: pain score ≤3 30 min after PACU arrival)
- Follow-up
- 30 minutes after arrival in the PACU
Methodological detailsdouble-blind, comparative, biased coin up-and-down sequential allocation, Trial concluded at 45 successful blocks, Initial concentration 0.20%; after success, same (probability 0.89) or 0.05% lower (probability 0.11); after failure, 0.05% higher
- Double-blind
- Comparative
- Biased coin up-and-down sequential allocation
- Trial concluded at 45 successful blocks
- Initial concentration 0.20%; after success, same (probability 0.89) or 0.05% lower (probability 0.11); after failure, 0.05% higher
Main finding
As reported in the abstract
MEC90 of ropivacaine
MEC90 of ropivacaine
0.340%
95% CI 0.329 to 0.344%
Original publication
Preoperative posterior quadratus lumborum block: determining the minimum effective ropivacaine concentration in 90% of patients (MEC90) for postoperative analgesia after laparoscopic myomectomy. Anaesth Crit Care Pain Med. Published 20 January 2025. doi:10.
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