Elsharkawy Hesham, Saasouh Wael, Cho Yoon Jeong, Soliman Loran Mounir, Horn Jean-Louis
Case Western Reserve University, Cleveland, OH, USA.
Outcomes Research Consortium, Cleveland Clinic, Cleveland, OH, USA.
J Anaesthesiol Clin Pharmacol. 2020 Jan-Mar;36(1):110-114. doi: 10.4103/joacp.JOACP_358_18. Epub 2020 Feb 18.
Liposomal bupivacaine (LB) is a formulation of local anesthetic that may exert analgesia over a prolonged period. Anecdotal use of LB suggests benefit and prolonged analgesia when used to supplement infiltration blocks. Our aim was to test the effect of a bolus of LB delivered through a nerve catheter in two types of interfascial plane blocks (transversus abdominis plane and anterior subcostal quadratus lumborum). The effect was evaluated through patient self-reporting of postsurgical pain up to 48 postoperative hours.
Medical records of adult postoperative patients who received LB in a peripheral nerve catheter were followed retrospectively and analysed for pain scores and spread of dermatomal numbness over 48 h following the postoperative dose. A chart review of patients who qualified between June 2015 and March 2017 was performed, and clinical data were obtained from the institutional Perioperative Health Documentation System.
Pain scores decreased following LB bolus, and all patients reported efficient block analgesia after bolus injection. Dermatomal numbness decreased gradually and was minimal by 48 h following bolus.
LB can be injected through a peripheral nerve catheter to prolong analgesia after catheter removal.
脂质体布比卡因（LB）是一种局部麻醉剂制剂，可能具有较长时间的镇痛作用。LB的轶事性使用表明，在用于补充浸润阻滞时具有益处且镇痛时间延长。我们的目的是测试通过神经导管推注LB在两种筋膜间平面阻滞（腹横肌平面阻滞和肋下腰方肌阻滞）中的效果。通过患者自我报告术后48小时内的术后疼痛来评估效果。
回顾性跟踪接受外周神经导管内注射LB的成年术后患者的病历，并分析术后剂量后48小时内的疼痛评分和皮节麻木范围。对2015年6月至2017年3月期间符合条件的患者进行病历审查，并从机构围手术期健康文档系统中获取临床数据。
推注LB后疼痛评分降低，所有患者在推注注射后均报告有效的阻滞镇痛。皮节麻木逐渐减轻，推注后48小时时降至最低。
LB可通过外周神经导管注射以在拔除导管后延长镇痛时间。
