Median Effective Dose of Ropivacaine for Prophylactic Cervical Cerclage in Chinese Women: A Dose-Finding Study

(Reg Anesth Pain Med. 2023;48:168–172. doi: 10.1136/rapm-2022-104242) Complications in pregnancy leading to preterm labor or miscarriage can occur for a variety of reasons. One reason that represents a significant public health burden is cervical incompetence or insufficiency. Current treatment guidelines focus on cervical cerclage as an effective treatment to prevent or arrest the effects of cervical insufficiency. Performing this procedure requires surgery, and therefore different anesthetic methods can be used to minimize pain and adverse outcomes for the patients, namely general or neuraxial anesthesia. One local anesthetic used for spinal neuraxial blocks in obstetrics is ropivacaine, but research has not explored its effect when used for cervical cerclage. This study from China was designed to find the median effective dose of intrathecal ropivacaine for cervical cerclage placement in 50% of patients (ED50). Secondary to this, the effective dose of intrathecal ropivacaine in 95% of patients (ED95) was also calculated. Other outcome measures included the duration of the sensory and motor blocks.