Department of Orthopaedic Surgery, Seoul National University College of Medicine, Korea.
Clin Orthop Surg. 2009 Mar;1(1):48-53. doi: 10.4055/cios.2009.1.1.48. Epub 2009 Feb 6.
This study evaluated the effectiveness of a continuous interscalene block (CISB) by comparing it with that of a single interscalene block combined with a continuous intra-bursal infusion of ropivacaine (ISB-IB) after arthroscopic rotator cuff repair.
Patients who had undergone CISB (CISB group; n = 25) were compared with those who had undergone ISB-IB (ISB-IB group; n = 25) for more than 48 hours after surgery. The visual analog scale (VAS) for pain, motor and/or sensory deficit, supplementary analgesics and adverse effects were recorded.
There were no significant differences between the postoperative VAS of the CISB and ISB-IB groups, except at 1 hour after surgery. Their supplementary analgesics of the two groups were similar. Transient motor weakness (52%) and sensory disturbance (40%) of the affected arm were observed in patients in the CISB group. The catheters came out accidentally in 22% of the CISB group but in only 4% of the ISB-IB group.
ISB-IB provides similar analgesia to CISB. However, the ISB-IB group had a lower incidence of neurological deficits and better catheter retention.
本研究通过比较连续锁骨下阻滞(CISB)与连续锁骨下入路联合罗哌卡因关节囊内持续输注(ISB-IB)在关节镜肩袖修复术后的效果,评估 CISB 的有效性。
比较接受 CISB(CISB 组;n = 25)和接受 ISB-IB 超过 48 小时(ISB-IB 组;n = 25)的患者。记录视觉模拟评分(VAS)疼痛、运动和/或感觉障碍、辅助镇痛和不良反应。
除术后 1 小时外,CISB 组和 ISB-IB 组的术后 VAS 无显著差异。两组的辅助镇痛药相似。CISB 组患者出现暂时性运动无力(52%)和感觉障碍(40%)。CISB 组中有 22%的导管意外脱出,而 ISB-IB 组只有 4%。
ISB-IB 提供与 CISB 相似的镇痛效果。然而,ISB-IB 组神经功能缺损发生率较低,导管留置情况更好。