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.
Pain Physician. 2020 Nov;23(6):589-597.
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.
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.
Randomized, double-blind, controlled trial.
University hospital setting.
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.
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.
Postoperative assessment of the offset of the sensory and motor blocks of the individualized nerves was inaccessible, in addition to a small sample size.
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.
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。
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。
随机、双盲、对照试验。
大学医院环境。
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。
温布比卡因组感觉和运动阻滞的起效时间明显加快。温布比卡因组感觉和运动阻滞的持续时间和首次需要镇痛的时间明显延长。此外，它还显著减少了术后镇痛药物的消耗。
除了样本量小之外，还无法对个体化神经感觉和运动阻滞的消退进行术后评估。
将 0.5%布比卡因加温至 37°C 可改善锁骨上臂丛阻滞的特性。它促进感觉-运动阻滞的快速起效，并提供更好的术后镇痛质量。
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