Department of Anesthesiology and Pain Medicine, School of Medicine, Konyang University, Daejeon, Korea.
Korean J Anesthesiol. 2010 Jul;59(1):27-33. doi: 10.4097/kjae.2010.59.1.27. Epub 2010 Jul 21.
A continuous interscalene brachial plexus block is a highly effective postoperative analgesic modality after shoulder surgery. However, there is no consensus regarding the optimal basal infusion rate of ropivacaine for a continuous interscalene brachial plexus block. A prospective, double blind study was performed to compare two different basal rates of 0.2% ropivacaine for a continuous interscalene brachial plexus block after shoulder surgery.
Sixty-two patients receiving shoulder surgery under an interscalene brachial plexus block were included. The continuous interscalene brachial plexus block was performed using a modified lateral technique with 30 ml of 0.5% ropivacaine. Surgery was carried out under an interscalene brachial plexus block or general anesthesia. After surgery, the patients were divided randomly into two groups containing 32 each. During the first 48 h after surgery, groups R8 and R6 received a continuous infusion of 0.2% ropivacaine at 8 ml/h and 6 ml/h, respectively. The pain scores at rest and on movement, supplemental analgesia, motor block, adverse events and patient's satisfaction were recorded.
The pain scores, supplemental analgesia, motor block, adverse events and patient's satisfaction were similar in the two groups.
When providing continuous interscalene brachial plexus block after shoulder surgery, 0.2% ropivacaine at a basal rate of 8 ml/h or 6 ml/h produces similar clinical efficacy. Therefore, decreasing the basal rate of CISB is more appropriate considering the toxicity of local anesthetics.
连续锁骨下臂丛神经阻滞是肩部手术后一种非常有效的术后镇痛方式。然而，对于连续锁骨下臂丛神经阻滞的罗哌卡因最佳基础输注率尚无共识。一项前瞻性、双盲研究比较了两种不同的 0.2%罗哌卡因基础输注率用于肩部手术后的连续锁骨下臂丛神经阻滞。
纳入 62 例接受锁骨下臂丛神经阻滞下肩部手术的患者。连续锁骨下臂丛神经阻滞采用改良外侧技术，用 30ml 0.5%罗哌卡因进行。手术在锁骨下臂丛神经阻滞或全身麻醉下进行。手术后，患者随机分为两组，每组 32 例。术后 48 小时内，R8 组和 R6 组分别以 8ml/h 和 6ml/h 的速度输注 0.2%罗哌卡因。记录静息和运动时的疼痛评分、辅助镇痛、运动阻滞、不良事件和患者满意度。
两组的疼痛评分、辅助镇痛、运动阻滞、不良事件和患者满意度相似。
肩部手术后行连续锁骨下臂丛神经阻滞时，基础输注率为 8ml/h 或 6ml/h 的 0.2%罗哌卡因产生相似的临床疗效。因此，考虑到局部麻醉药的毒性，降低 CISB 的基础输注率更为合适。
