Background : Optimal dose of local anesthetics for supraclavicular brachial plexus block (BPB) is still unknown. We prospectively investigated the analgesic effect of ultrasound-guided continuous supraclavicular BPB with ropivacaine at different infusion rates. Methods : Thirty-nine patients scheduled to undergo shoulder surgery were randomly assigned to four groups ; receiving no continuous BPB (control group, n=10), BPB with 0.2% of ropivacaine at an infusion rate of 4 ml·hr-1 (n=12), BPB with 6 ml·hr-1 (n=12) or BPB with 8 ml·hr-1 (n=5). All patients were permitted to receive nonsteroidal anti-inflammatory drugs (NSAIDs) after surgery. Visual analogue scale (VAS) for postoperative pain was assessed and frequencies of the requirement of NSAIDs were recorded in each group. Results : The pain scores during 24 hours after surgery in the 6 ml·hr-1 group (3-24 mm) were significantly lower than those in the 4 ml·hr-1 group (4-42 mm) and control group (6-56 mm). Mean frequency of administrations of NSAIDs for 24 hours after surgery in the 6 ml·hr-1 (0.8±0.8) group was significantly lower than that in the control group (1.7±1.0). Continuous administration in two cases in the 8 ml·hr-1 group was discontinued due to leakage of local anesthetics and headache. Conclusions : Continuous supraclavicular BPB with 0.2% ropivacaine at 6 ml·hr-1 is effective for the pain management after shoulder surgery and is not an excess dose.
|ジャーナル||Japanese Journal of Anesthesiology|
|出版ステータス||Published - 2010 11月 10|
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