Aksu Recep, Biçer Cihangir, Ülgey Ayşe, Bayram Adnan, Güneş Işın, Güney Ahmet, Yıldırım Mustafa Denizhan, Gökahmetoğlu Günhan, Yıldız Karamehmet
Departamento de Anestesiologia, Faculdade de Medicina, Universidade Erciyes, Kayseri, Turquia.
Departamento de Anestesiologia, Faculdade de Medicina, Universidade Erciyes, Kayseri, Turquia.
Rev Bras Anestesiol. 2015 May-Jun;65(3):222-9. doi: 10.1016/j.bjan.2014.06.007. Epub 2015 Apr 2.
In this study, the aim was to compare postoperative analgesia effects of the administration of ultrasound-guided interscalene brachial plexus block and intra-articular bupivacaine carried out with bupivacaine.
In the first group of patients 20mL 0.25% bupivacaine and ultrasound-guided interscalene brachial plexus block (ISPB) were applied, while 20mL 0.25% bupivacaine was given via intra-articular (IA) administration to the second group patients after surgery. Patients in the third group were considered the control group and no block was performed. Patient-controlled analgesia (PCA) with morphine was used in all three groups for postoperative analgesia.
In the ISPB group, morphine consumption in the periods between 0-4, 6-12 and 12-24 postoperative hours and total consumption within 24h was lower than in the other two groups. Morphine consumption in the IA group was lower than in the control group in the period from 0 to 6h and the same was true for total morphine consumption in 24h. Postoperative VASr scores in the ISPB group were lower than both of the other groups in the first 2h and lower than the control group in the 4(th) and 6(th) hours (p<0.05). In the IA group, VASr and VASm scores in the 2(nd), 4(th) and 6(th) hours were lower than in the control group (p<0.05).
Interscalene brachial plexus block was found to be more effective than intra-articular local anesthetic injection for postoperative analgesia.
本研究旨在比较超声引导下肌间沟臂丛神经阻滞联合布比卡因与关节腔内注射布比卡因的术后镇痛效果。
第一组患者采用20mL 0.25%布比卡因行超声引导下肌间沟臂丛神经阻滞（ISPB），第二组患者术后经关节腔内（IA）给予20mL 0.25%布比卡因。第三组患者为对照组，未行阻滞。三组患者术后均采用吗啡自控镇痛（PCA）。
ISPB组术后0 - 4小时、6 - 12小时及12 - 24小时的吗啡用量及24小时内的总用量均低于其他两组。IA组术后0至6小时的吗啡用量低于对照组，24小时内的吗啡总用量情况亦如此。ISPB组术后2小时内的VASr评分低于其他两组，第4小时和第6小时低于对照组（p<0.05）。IA组在第2小时、第4小时和第6小时的VASr及VASm评分低于对照组（p<0.05）。
肌间沟臂丛神经阻滞在术后镇痛方面比关节腔内局部麻醉注射更有效。
