Tariq Alzahrani, Abdulaziz Al-Ahaideb
Department of Anesthesiology, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia.
Saudi J Anaesth. 2011 Apr;5(2):190-4. doi: 10.4103/1658-354X.82798.
Interscalene brachial plexus block (ISBPB) is an effective technique for shoulder surgery and postoperative pain control. The aim of this study is to compare the analgesic efficacy of 0.1% vs 0.2% bupivacaine for continuous postoperative pain control following arthroscopic shoulder surgery.
A total of 40 adult patients divided into two groups (each 20 patients) undergoing arthroscopic shoulder surgery were randomized to receive an ultrasound-guided ISBPB of either 0.1% or 0.2% bupivacaine 10 ml bolus plus 5 ml/h infusion through interscalene catheter. Standard general anesthesia was given. Both groups received rescue postoperative PCA morphine. Pain, sensory, and motor power were assessed before for all patients, 20 minute after the block, postoperatively in the recovery room, and at 2, 6, 12, and 24 hours thereafter. The patient and surgeon satisfaction and the analgesic consumption of morphine were recorded in the first 24 hours postoperatively. A nonparametric Mann-Whitney was used to compare between the two groups for numerical rating scale, morphine consumption in different time interval.
Group 1 (0.1% bupivacaine) patients had significantly received more intraoperative fentanyl and postoperative morphine with higher pain scores at 24 hours postoperatively vs group 2 (0.2% bupivacaine) patients.
The use of ultrasound-guided ISBPB with 0.2% bupivacaine provided better intra- and post-operative pain relief vs 0.1% bupivacaine in arthroscopic shoulder surgery.
肌间沟臂丛神经阻滞（ISBPB）是一种用于肩部手术和术后疼痛控制的有效技术。本研究的目的是比较0.1%与0.2%布比卡因在关节镜肩部手术后持续术后疼痛控制中的镇痛效果。
总共40例接受关节镜肩部手术的成年患者被随机分为两组（每组20例），接受超声引导下的ISBPB，分别注射10 ml的0.1%或0.2%布比卡因推注，再通过肌间沟导管以5 ml/h的速度输注。给予标准全身麻醉。两组患者术后均接受PCA吗啡补救。在术前、阻滞后20分钟、术后恢复室以及此后的2、6、12和24小时对所有患者进行疼痛、感觉和运动能力评估。记录术后24小时内患者和外科医生的满意度以及吗啡的镇痛用量。采用非参数曼-惠特尼检验比较两组在数字评分量表、不同时间间隔的吗啡用量方面的差异。
与第2组（0.2%布比卡因）患者相比，第1组（0.1%布比卡因）患者术中接受了更多的芬太尼，术后接受了更多的吗啡，术后24小时疼痛评分更高。
在关节镜肩部手术中，使用0.2%布比卡因的超声引导下ISBPB比0.1%布比卡因在术中和术后提供了更好的疼痛缓解。
