左旋布比卡因与罗哌卡因用于臂丛神经阻滞的术后镇痛比较：一项随机前瞻性试验。
Postoperative analgesia comparing levobupivacaine and ropivacaine for brachial plexus block: A randomized prospective trial.
作者信息
Watanabe Kunitaro, Tokumine Joho, Lefor Alan Kawarai, Moriyama Kumi, Sakamoto Hideaki, Inoue Tetsuo, Yorozu Tomoko
机构信息
Department of Anesthesiology, Kyorin University School of Medicine, Shinkawa, Mitaka, Tokyo, Japan Department of Surgery, Jichi Medical University, Yakushiji, Shimotsuke, Tochigi, Japan Department of Anesthesia, Hino Munichipal Hospital, Tamadaira, Hino, Tokyo, Japan.
出版信息
Medicine (Baltimore). 2017 Mar;96(12):e6457. doi: 10.1097/MD.0000000000006457.
BACKGROUND
On a pharmacologic basis, levobupivacaine is expected to last longer than ropivacaine. However, most reports of these anesthetics for brachial plexus block do not suggest a difference in analgesic effect. The aim of this study is to compare the postoperative analgesic effects of levobupivacaine and ropivacaine when used for treating ultrasound-guided brachial plexus block.
METHODS
A total of 62 patients undergoing orthopedic surgery procedures were prospectively enrolled and randomized to receive levobupivacaine (group L, N = 31) or ropivacaine (group R, N = 31). The duration of analgesia, offset time of motor block, need for rescue analgesics, and sleep disturbance on the night of surgery were recorded. Pain score was recorded on the day of surgery, and on postoperative days 1 and 2.
RESULTS
There was no difference in the time interval until the first request for pain medication comparing the two groups (group L: 15.6 [11.4, 16.8] hours; group R: 12.5 [9.4, 16.0] hours, P = 0.32). There was no difference in the duration of motor block (group L: 12.2 [7.6, 14.4] hours; group R: 9.4 [7.9, 13.2] hours, P = 0.44), pain score (P = 0.92), need for rescue analgesics (group L: 55%; group R: 65%, P = 0.6), or rate of sleep disturbance (group L: 61%, group R: 58%, P = 1.0) on comparing the two groups.
CONCLUSIONS
There was no difference in postoperative analgesia comparing levobupivacaine and ropivacaine when used for brachial plexus block.
背景
从药理学角度来看，左旋布比卡因预计比罗哌卡因作用时间更长。然而，关于这些麻醉剂用于臂丛神经阻滞的大多数报告并未显示镇痛效果存在差异。本研究的目的是比较左旋布比卡因和罗哌卡因用于超声引导下臂丛神经阻滞时的术后镇痛效果。
方法
共有62例接受骨科手术的患者被前瞻性纳入并随机分为两组，分别接受左旋布比卡因（L组，N = 31）或罗哌卡因（R组，N = 31）。记录镇痛持续时间、运动阻滞消退时间、使用补救性镇痛药的需求以及手术当晚的睡眠障碍情况。在手术当天、术后第1天和第2天记录疼痛评分。
结果
两组患者首次要求使用止痛药物的时间间隔无差异（L组：15.6 [11.4, 16.8]小时；R组：12.5 [9.4, 16.0]小时，P = 0.32）。两组在运动阻滞持续时间（L组：12.2 [7.6, 14.4]小时；R组：9.4 [7.9, 13.2]小时，P = 0.44）、疼痛评分（P = 0.92）、使用补救性镇痛药的需求（L组：55%；R组：65%，P = 0.6）或睡眠障碍发生率（L组：61%，R组：58%，P = 1.0）方面均无差异。
结论
左旋布比卡因和罗哌卡因用于臂丛神经阻滞时，术后镇痛效果无差异。
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