Department of Anesthesiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, No. 88 Jiefang Rd, Hangzhou, 310009, Zhejiang, China.
Department of Anesthesiology, Cixi People Hospital Medical Health Group (Cixi People Hospital), NO.999 The Second Ring of the South Road, Hushan Street, Cixi, 315300, Zhejiang, China.
BMC Anesthesiol. 2023 Nov 13;23(1):372. doi: 10.1186/s12871-023-02332-5.
There is a long latent period for the sciatic nerve block before a satisfactory block is attained. Changes in the temperature of local anesthetics may influence the characters of the peripheral nerve block. This study was designed to evaluate the effect of warming ropivacaine on the ultrasound-guided subgluteal sciatic nerve block.
Fifty-four patients for distal lower limbs surgery were randomly allocated into warming group (group W, n = 27) or room tempeture group (group R, n = 27) with the ultrasound-guided subgluteal sciatic nerve block. The group W received 30 ml of ropivacaine 0.5% at 30℃ and the group R received 30 ml of ropivacaine 0.5% at 23℃. The sensory and motor blockade were assessed every 2 min for 30 min after injection. The primary outcome was the onset time of limb sensory blockade.
The onset time of sensory blockade was shorter in group W than in group R (16 (16,18) min vs 22 (20,23) min, p < 0.001), and the onset time of motor blockade was also shorter in group W than in group R (22 (20,24) min vs 26 (24,28) min, p < 0.001). The onset time of sensory blockade for each nerve was shorter in group W than in group R (p < 0.001). No obvious differences for the duration of sensory and motor blockade and the patient satisfaction were discovered between both groups. No complications associated with nerve block were observed 2 days after surgery.
Warming ropivacaine 0.5% to 30℃ accelerates the onset time of sensory and motor blockade in the ultrasound-guided subgluteal sciatic nerve block and it has no influence on the duration of sensory and motor blockade.
The trial was registered on October 3, 2022 in the Chinese Clinical Trial Registry ( https://www.chictr.org.cn/bin/project/edit?pid=181104 ), registration number ChiCTR2200064350 (03/10/2022).
坐骨神经阻滞达到满意阻滞效果前存在较长潜伏期。局麻药温度变化可能影响外周神经阻滞特性。本研究旨在评估温热罗哌卡因对超声引导下臀下入路坐骨神经阻滞的影响。
54 例拟行下肢远端手术的患者随机分为温热组（W 组，n=27）或室温组（R 组，n=27），行超声引导下臀下入路坐骨神经阻滞。W 组接受 30ml 0.5%罗哌卡因（30℃），R 组接受 30ml 0.5%罗哌卡因（23℃）。注药后每 2min 评估 1 次感觉和运动阻滞，共 30min。主要结局为肢体感觉阻滞的起效时间。
W 组感觉阻滞的起效时间短于 R 组[16（16，18）min 比 22（20，23）min，p<0.001]，运动阻滞的起效时间也短于 R 组[22（20，24）min 比 26（24，28）min，p<0.001]。W 组各神经感觉阻滞的起效时间均短于 R 组（p<0.001）。两组间感觉和运动阻滞持续时间和患者满意度差异无统计学意义。术后 2d 无与神经阻滞相关的并发症发生。
温热 0.5%罗哌卡因至 30℃可加快超声引导下臀下入路坐骨神经阻滞的感觉和运动阻滞起效时间，对感觉和运动阻滞持续时间无影响。
该试验于 2022 年 10 月 3 日在中国临床试验注册中心（https://www.chictr.org.cn/bin/project/edit?pid=181104）注册，注册号 ChiCTR2200064350（03/10/2022）。
