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左旋布比卡因与布比卡因用于锁骨上阻滞的效能:一项随机双盲对照研究。

Efficiency of levobupivacaine and bupivacaine for supraclavicular block: a randomized double-blind comparative study.

作者信息

Ilham Cenk, Bombaci Elif, Yurtlu Serhan, Çolakoğlu Serhan

机构信息

Dr. Lütfi Kırdar Research and Education Hospital, Istanbul, Turkey.

Dr. Lütfi Kırdar Research and Education Hospital, Istanbul, Turkey.

出版信息

Braz J Anesthesiol. 2014 May-Jun;64(3):177-82. doi: 10.1016/j.bjane.2013.03.015. Epub 2013 Oct 23.

DOI:10.1016/j.bjane.2013.03.015
PMID:24907877
Abstract

BACKGROUND AND OBJECTIVES

Success rate of catheter applications is low in supraclavicular block. Thus, bupivacaine and levobupivacaine become important with their long effect time in single injection practices. In this study, we aimed to compare the effectiveness, side effects and complications of bupivacaine and levobupivacaine in supraclavicular block.

METHODS

Sixty patients aged between 20 and 65, with body weight between 50 and 100 kg, in the ASA I-II-III group who were scheduled for hand, forearm and arm surgery using supraclavicular block were randomized into two groups of 30. The patients received 30 ml 0.5% bupivacaine (Group B) or 30 ml 0.5% levobupivacaine (Group L). Motor and sensory blocks were evaluated. Motor and sensory block onset times, total block durations, postoperative pain, amount of postoperative analgesic used and patient satisfaction were recorded.

RESULTS

Demographic data, distribution of surgical area and hemodynamic data were similar between the two groups. Surgery, motor and sensory block durations of Group B and L patients did not vary statistically significantly. However, motor and sensory block onset times in Group B were significantly shorter than Group L (p<0.05). The mean time for first postoperative analgesic demand were 16.6 ± 8.0 h in Group B and 14.4 ± 7.3h in Group L (p>0.05).

CONCLUSION

30 ml 0.5% bupivacaine and levobupivacaine provide similar block characteristics for supraclavicular block. Bupivacaine leads to faster motor and sensory block onset compared to levobupivacaine however similar duration of postoperative analgesia.

摘要

背景与目的

锁骨上阻滞中导管置入成功率较低。因此,布比卡因和左旋布比卡因因其单次注射时效长而变得重要。在本研究中,我们旨在比较布比卡因和左旋布比卡因在锁骨上阻滞中的有效性、副作用及并发症。

方法

将年龄在20至65岁之间、体重在50至100千克、ASA分级为I-II-III级、计划行手部、前臂和上臂手术并采用锁骨上阻滞的60例患者随机分为两组,每组30例。患者分别接受30毫升0.5%布比卡因(B组)或30毫升0.5%左旋布比卡因(L组)。评估运动和感觉阻滞情况。记录运动和感觉阻滞起效时间、总阻滞持续时间、术后疼痛、术后镇痛药物用量及患者满意度。

结果

两组患者的人口统计学数据、手术区域分布及血流动力学数据相似。B组和L组患者的手术、运动和感觉阻滞持续时间差异无统计学意义。然而,B组的运动和感觉阻滞起效时间显著短于L组(p<0.05)。B组术后首次镇痛需求的平均时间为16.6±8.0小时,L组为14.4±7.3小时(p>0.05)。

结论

30毫升0.5%布比卡因和左旋布比卡因用于锁骨上阻滞时具有相似的阻滞特征。与左旋布比卡因相比,布比卡因导致运动和感觉阻滞起效更快,但术后镇痛持续时间相似。

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