Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea.
Department of Anesthesia and Pain Medicine, College of Medicine, International St. Mary's Hospital, Catholic Kwandong University, Incheon, 22711, Korea.
Sci Rep. 2021 Feb 25;11(1):4703. doi: 10.1038/s41598-021-84172-2.
At centers with pressure on rapid operating room turnover, onset time is one of the important considerations for choosing a local anesthetic drug. To hasten the onset of the block, higher concentrations of local anesthetics are sometimes used. However, the use of diluted local anesthetics may be safer. Therefore, we aimed to compare the onset times of equipotential levobupivacaine and ropivacaine at low concentrations for infraclavicular brachial plexus block. Adult patients undergoing upper extremity surgery under ultrasound-guided infraclavicular brachial plexus block at our center were randomly allocated to the levobupivacaine and ropivacaine groups. Infraclavicular brachial plexus block was induced with 0.25% levobupivacaine or 0.375% ropivacaine depending on the assigned group. The degrees of sensory and motor blockade were assessed for 40 min after the administration of local anesthetics. A total of 46 patients were included in the analysis. Infraclavicular brachial plexus block with 0.25% levobupivacaine and 0.375% ropivacaine provided sufficient surgical anesthesia. The sensory onset time of 0.375% ropivacaine was shorter than that of 0.25% levobupivacaine (group R, 15 [15.0-22.5] min; group L, 30 [17.5-35.0] min, p = 0.001). There were no significant differences in other block characteristics and clinical outcomes between the two groups. Thus, when a quicker block onset is required, 0.375% ropivacaine is a better choice than 0.25% levobupivacaine.Trial registration ClinicalTrials.gov (NCT03679897).
在手术间周转率压力较大的中心，起效时间是选择局部麻醉药物的重要考虑因素之一。为了加速阻滞的起效，有时会使用更高浓度的局部麻醉剂。然而，使用稀释的局部麻醉剂可能更安全。因此，我们旨在比较低浓度等比重左旋布比卡因和罗哌卡因用于锁骨下臂丛神经阻滞的起效时间。在我们中心接受超声引导下锁骨下臂丛神经阻滞的上肢手术的成年患者，按照随机数字表法分配至左旋布比卡因组和罗哌卡因组。根据分组，锁骨下臂丛神经阻滞采用 0.25%左旋布比卡因或 0.375%罗哌卡因诱导。在局部麻醉剂给药后 40 分钟评估感觉和运动阻滞程度。共有 46 例患者纳入分析。0.25%左旋布比卡因和 0.375%罗哌卡因行锁骨下臂丛神经阻滞可提供充分的手术麻醉。0.375%罗哌卡因的感觉起效时间短于 0.25%左旋布比卡因（组 R：15[15.0-22.5]min；组 L：30[17.5-35.0]min，p=0.001）。两组在其他阻滞特征和临床结局方面无显著差异。因此，当需要更快的阻滞起效时，0.375%罗哌卡因是比 0.25%左旋布比卡因更好的选择。
ClinicalTrials.gov（NCT03679897）。
