Anesthesiology Department, Faculty of Medicine, Cairo University, Kasr Alainy Street, Cairo, Egypt.
Anesthesia Department, Faculty of Medicine, Cairo University, Kasr Alainy Street, Cairo, Egypt.
J Anesth. 2018 Aug;32(4):551-557. doi: 10.1007/s00540-018-2512-x. Epub 2018 May 28.
Prolonged postoperative analgesia with early motor recovery for early rehabilitation is a challenge in regional block. The purpose of this study is to evaluate the effect of adding 20 mg nalbuphine to 25 ml of 0.25% levobupivacaine in supraclavicular brachial plexus block.
One hundred thirty-five (135) patients scheduled for hand and forearm surgeries with supraclavicular block were randomly allocated into three equal groups. Group L received 25 ml of 0.5% levobupivacaine + 1 ml normal saline; group H received 25 ml of 0.25% levobupivacaine + 1 ml normal saline; and group N received 25 ml of 0.25% levobupivacaine + 1 ml (20 mg) nalbuphine. Onset time and duration of sensory and motor block, and time to first analgesic dose were recorded.
Sensory block onset was comparable between the three groups. Motor block onset in group L and group N was comparable (13.16 ± 3.07 and 13.84 ± 3.05 min, respectively) and was shorter than that in group H (15.71 ± 2 0.91 min). Sensory block duration in group L and group N was comparable (522.22 ± 69.57 and 533.78 ± 66.03 min, respectively) and was longer than that in group H (342.67 ± 92.80 min). Motor block duration in group N and group H was comparable (272.00 ± 59.45 and 249.78 ± 66.01 min, respectively) and was shorter than that in group L (334.67 ± 57.90 min). Time to first analgesic dose was significantly longer in group N (649.78 ± 114.76 min) than that of group L and group H (575.56 ± 96.85 and 375.56 ± 84.49 min, respectively) and longer in group L when compared to group H.
Adding 20 mg nalbuphine to 25 ml of 0.25% levobupivacaine in supraclavicular block provided prolonged duration of sensory block with similar duration of motor block.
在区域阻滞中，实现术后长时间镇痛和早期运动恢复是一项挑战。本研究旨在评估在锁骨上臂丛阻滞中加入 20mg 纳布啡对 25ml0.25%左布比卡因的影响。
135 例拟行手部和前臂手术的患者随机分为三组。L 组接受 25ml0.5%左布比卡因+1ml生理盐水；H 组接受 25ml0.25%左布比卡因+1ml生理盐水；N 组接受 25ml0.25%左布比卡因+1ml（20mg）纳布啡。记录感觉和运动阻滞的起效时间和持续时间，以及首次镇痛剂量的时间。
三组之间的感觉阻滞起效时间无显著差异。L 组和 N 组的运动阻滞起效时间相似（分别为 13.16±3.07min 和 13.84±3.05min），均短于 H 组（15.71±20.91min）。L 组和 N 组的感觉阻滞持续时间相似（分别为 522.22±69.57min 和 533.78±66.03min），均长于 H 组（342.67±92.80min）。N 组和 H 组的运动阻滞持续时间相似（分别为 272.00±59.45min 和 249.78±66.01min），均短于 L 组（334.67±57.90min）。N 组首次镇痛剂量的时间明显长于 L 组和 H 组（649.78±114.76min、575.56±96.85min 和 375.56±84.49min），也长于 L 组。
在锁骨上臂丛阻滞中加入 20mg 纳布啡可延长感觉阻滞的持续时间，同时保持运动阻滞的持续时间相似。
