Little Kevin, Pillai Anand, Fazzi Umberto, Storey Neil
West of Scotland Deanery Orthopaedic Rotation, Glasgow, UK.
Ann R Coll Surg Engl. 2007 May;89(4):410-3. doi: 10.1308/003588407X183300.
The use of extended local anaesthesia for postoperative pain has previously been reported, and has several advantages over other methods, including ease of placement, safety, reliability, lower cost and effective analgesia. We present our experience with a portable elastomeric infusion device in patients undergoing arthroscopic subacromial decompression, and make a case for its potential to allow same-day discharge.
Forty patients undergoing arthroscopic subacromial decompression were followed-up. At the end of the procedure, an epidural catheter connected to a portable elastomeric local anaesthetic infusion system was inserted into the subacromial space. All patients were electively admitted for overnight stay postoperatively and assessed using a visual analogue scale (VAS) to evaluate their level of pain.
No patient reported severe pain at any stage. None of the patients required any parenteral opiate analgesia with the pump in situ.
These findings suggest that the use of this elastomeric infusion device following shoulder surgery allows safe and early discharge of patients with decreased need for parenteral opiate analgesia.
先前已有关于使用延长局部麻醉进行术后镇痛的报道,与其他方法相比,它具有几个优点,包括放置简便、安全性高、可靠性强、成本较低以及镇痛效果良好。我们介绍了在接受关节镜下肩峰下减压术的患者中使用便携式弹性体输注装置的经验,并论证了其实现当日出院的潜力。
对40例接受关节镜下肩峰下减压术的患者进行随访。手术结束时,将连接便携式弹性体局部麻醉输注系统的硬膜外导管插入肩峰下间隙。所有患者术后均被选择性收治住院过夜,并使用视觉模拟量表(VAS)进行评估,以评价其疼痛程度。
无患者在任何阶段报告严重疼痛。在泵在位的情况下,没有患者需要任何胃肠外阿片类镇痛药物。
这些发现表明,肩部手术后使用这种弹性体输注装置可使患者安全、早日出院,且减少了对胃肠外阿片类镇痛药物的需求。