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低剂量左旋布比卡因用于超声引导下肌间沟臂丛神经阻滞在肩关节镜手术中的镇痛效果

Analgesic effect of low-dose levobupivacaine for ultrasound-guided interscalene brachial plexus block for arthroscopic shoulder surgery.

作者信息

Kim Jang Jae, Kim Chi Hyo, Kim Youn Jin, Kim Dong Yeon, Han Jong In

机构信息

Department of Anesthesiology and Pain Medicine, School of Medicine, Ewha Womans University, Seoul, Korea.

出版信息

Korean J Anesthesiol. 2009 Sep;57(3):302-307. doi: 10.4097/kjae.2009.57.3.302.

Abstract

BACKGROUND

Ultrasound guided-interscalene brachial plexus block (US-ISBPB) becomes more popular and has higher success rate. The aim of this study was to assess the analgesic effectiveness of US-ISBPB with low dose levobupivacaine for arthroscopic shoulder surgery.

METHODS

The thirty patients undergoing elective arthroscopic shoulder surgery were randomly assigned to two groups: Group B(0.5), and Group B(0.25) received ultrasound-guided ISBPB using same volume 10 ml of 0.5% levobupivacaine and 0.25% levobupivacaine, respectively. General anesthesia was standardized. All patients received continuous intra-articular infusion of a local anesthetic. Remifentanil consumption during operation, verbal numerical rating scales (VNRS) after operation were assessed. The need for rescue analgesics in post-anesthesia care unit (PACU), sleep quality, and complications were documented.

RESULTS

There were no significant differences in VNRS at 20 min, 30 min, 60 min, 120 min, 8 h, 24 h after surgery, remifentanil consumption during operation, the number of patients required rescue analgesics in the PACU, sleep quality, and complication up to 24 h after surgery.

CONCLUSIONS

Ultrasound-guided interscalene brachial plexus block with levobupivacaine, 10 ml of 0.5% and 0.25%, provides effective analgesia after arthroscopic shoulder surgery.

摘要

背景

超声引导下肌间沟臂丛神经阻滞(US-ISBPB)越来越受欢迎且成功率更高。本研究的目的是评估低剂量左旋布比卡因用于超声引导下肌间沟臂丛神经阻滞对肩关节镜手术的镇痛效果。

方法

30例行择期肩关节镜手术的患者被随机分为两组:B(0.5)组和B(0.25)组,分别使用10 ml的0.5%左旋布比卡因和0.25%左旋布比卡因接受超声引导下肌间沟臂丛神经阻滞。全身麻醉标准化。所有患者均接受关节腔内持续局部麻醉药输注。评估术中瑞芬太尼用量、术后视觉模拟评分法(VNRS)。记录麻醉后恢复室(PACU)中使用补救镇痛药的需求、睡眠质量和并发症情况。

结果

术后20分钟、30分钟、60分钟、120分钟、8小时、24小时的VNRS、术中瑞芬太尼用量、PACU中需要补救镇痛药的患者数量、睡眠质量以及术后24小时内的并发症方面,两组间均无显著差异。

结论

10 ml的0.5%和0.25%左旋布比卡因用于超声引导下肌间沟臂丛神经阻滞,可为肩关节镜手术后提供有效的镇痛效果。

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