Byrne Kelly P, Smith Clare L, Termaat Jonathan, Tsui Ban C H
Department of Anaesthesia, Waikato Hospital, Hamilton, New Zealand.
Department of Anaesthesiology and Pain Medicine, Stanford University, Stanford, California, USA.
Turk J Anaesthesiol Reanim. 2020 Apr;48(2):115-119. doi: 10.5152/TJAR.2019.09076. Epub 2019 Oct 17.
The objective of the present study was to determine whether or not the effects of peripheral nerve block can be reversed by flushing normal saline down a peripheral nerve block catheter following the completion of arteriovenous (AV) fistula surgery.
In the present study, 38 patients undergoing AV fistula surgery were recruited, and a brachial plexus block with a peripheral nerve catheter was established. Following surgery, the patients were randomised to either the control group or the washout group, where 10 mL of normal saline was flushed down the peripheral nerve catheter at 15-minute intervals for 1 h while the patients were in the postoperative recovery room. An observer blinded to the patient group allocation assessed motor and sensory functions in all patients at 15-minute intervals for 1 h, and pain scores were recorded.
There was no difference in time to resolution of motor or sensory block in the two groups. The median changes in the motor score were 1.5 out of 10 for the control group and 2 for the washout group (p=0.95). The median changes in the sensory score were 3 out of 10 for the control group and 1 for the washout group (p=0.14). There were no differences in pain scores over the study period in either group (p=0.44).
We were unable to show any useful improvement in block resolution with normal saline washout of supraclavicular or infraclavicular brachial plexus blocks following AV fistula surgery.
本研究的目的是确定动静脉（AV）瘘手术后通过外周神经阻滞导管冲洗生理盐水是否能逆转外周神经阻滞的效果。
在本研究中，招募了38例行AV瘘手术的患者，并建立了外周神经导管臂丛神经阻滞。手术后，患者被随机分为对照组或冲洗组，当患者在术后恢复室时，每隔15分钟通过外周神经导管冲洗10 mL生理盐水，持续1小时。一名对患者分组不知情的观察者每隔15分钟对所有患者的运动和感觉功能进行评估，持续1小时，并记录疼痛评分。
两组运动或感觉阻滞消退时间无差异。对照组运动评分的中位数变化为10分制中的1.5分，冲洗组为2分（p = 0.95）。对照组感觉评分的中位数变化为10分制中的3分，冲洗组为1分（p = 0.14）。两组在研究期间的疼痛评分均无差异（p = 0.44）。
我们未能证明AV瘘手术后通过生理盐水冲洗锁骨上或锁骨下臂丛神经阻滞在阻滞消退方面有任何有益的改善。
