布比卡因温度对锁骨上神经阻滞特征的影响：一项随机对照试验。

The Influence of Bupivacaine Temperature on Supraclavicular Plexus Block Characteristics: A Randomized, Controlled Trial.

机构信息

Departments of Anesthesiology and Surgical Intensive Care, Faculty of Medicine, Mansoura University, Egypt.

Department of Anesthesiology and Surgical Intensive Care, Faculty of Medicine, Mansoura University, Mansoura, Egypt.

出版信息

Pain Physician. 2020 Nov;23(6):589-597.

PMID:33185376

Abstract

BACKGROUND

Changes in local anesthetics temperature may influence the characters of the peripheral nerve block. The effect of warmed bupivacaine on supraclavicular brachial plexus block has not yet been evaluated.

OBJECTIVES

This study was designed to evaluate the influence of warming bupivacaine 0.5% on the characteristics of supraclavicular plexus block in adult patients undergoing orthopedic surgery below the mid-arm. The primary objective was the time to onset of sensory block. The secondary objectives were the time to onset of motor block, the duration of sensory and motor blocks, and the time to the first analgesic requirement.

STUDY DESIGN

Randomized, double-blind, controlled trial.

SETTING

University hospital setting.

METHODS

Ninety patients who underwent elective or emergency orthopedic surgery below the mid-arm were included in this study. Patients were randomly allocated into 2 groups and received ultrasound-guided supraclavicular brachial plexus block. Group I received 30 mL 0.5% bupivacaine at 23°C. Group II received 30 mL bupivacaine 0.5% warmed to 37°C. The onset of sensory and motor blocks, postoperative pain severity, the duration of sensory and motor blocks, and the time to the first analgesic requirement were evaluated in all patients.

RESULTS

The warm bupivacaine group had a significantly accelerated onset time of sensory and motor block. The duration of sensory and motor block and the time to first requirement for analgesia were significantly longer in the warm bupivacaine group. Moreover, it significantly reduced the postoperative analgesics consumption.

LIMITATIONS

Postoperative assessment of the offset of the sensory and motor blocks of the individualized nerves was inaccessible, in addition to a small sample size.

CONCLUSIONS

Warming bupivacaine 0.5% to 37°C improves the characteristics of supraclavicular plexus block. It promotes rapid onset of sensory-motor block and provided better quality of postoperative analgesia.

摘要

背景

局部麻醉剂温度的变化可能会影响周围神经阻滞的特性。尚未评估加温布比卡因对锁骨上臂丛阻滞的影响。

目的

本研究旨在评估加温 0.5%布比卡因对成人中臂以下骨科手术患者锁骨上臂丛阻滞特征的影响。主要目的是感觉阻滞的起效时间。次要目标是运动阻滞的起效时间、感觉和运动阻滞的持续时间以及首次需要镇痛的时间。

研究设计

随机、双盲、对照试验。

设置

大学医院环境。

方法

本研究纳入了 90 例接受中臂以下择期或急诊骨科手术的患者。患者被随机分配到 2 组，并接受超声引导下锁骨上臂丛阻滞。组 I 接受 30 mL 23°C 0.5%布比卡因。组 II 接受 30 mL 加温至 37°C 的 0.5%布比卡因。所有患者均评估感觉和运动阻滞的起始、术后疼痛严重程度、感觉和运动阻滞的持续时间以及首次需要镇痛的时间。