- 作者：Juergen Birnbaum ; Miriam Kip ; Claudia D. Spies ; Ortrud Vargas Hein ; Karsten Labs ; Gregor Moeckel ; Thomas Volk
- 关键词：Catheter technique ; Interscalene brachial plexus block ; Postoperative analgesia ; Ropivacaine plasma concentrations ; Stimulating catheter
- 刊名：Journal of Clinical Anesthesia
- 出版年：2007
- 期刊代码：147_09528180
- 类别：med
- 出版时间：September 2007
- 卷：19
- 期：6
- 页码：434-439
- 文件大小：236 K
Design
Controlled, prospective, randomized, pilot study.
Setting
University hospital.
Patients
60 patients undergoing shoulder surgery.
Interventions and Main Measurements
The brachial plexus was identified using a stimulating needle. In conventional catheter group 1 (CC 1), local anesthetic (LA) was injected through the needle and catheters were advanced blindly thereafter. In catheter group 2 (CC 2), catheters were blindly inserted and LA was injected through the catheter. In the stimulating catheter group (SC), LA was injected only after catheter tip location was confirmed by nerve stimulation. Time required to perform the block, pain intensity at rest, and dynamic pain (defined movement: lifting of arm; numeric rating scale, 0-10), patient satisfaction (verbal rating scale, Likert scale), and plasma concentrations of ropivacaine were measured.
Main Results
Patients in the SC group had significantly decreased pain scores. The median block performance time was 6 minutes in CC 1 (CI 25%-75%: 4-8 min), 11 minutes in CC 2 (CI 25%-75%: 7-13 min), and 12 minutes in SC (CI 25%-75%: 10-24 min). Patient satisfaction and plasma concentrations of ropivacaine did not differ among the groups.
Conclusions
Stimulating catheters for interscalene plexus blocks improve postoperative analgesia at rest in patients undergoing shoulder surgery.