Interscalene brachial plexus block for open-shoulder surgery: a randomized, double-blind, placebo-controlled trial between single-shot anesthesia and patient-controlled catheter system
| Autor: | Frank Gohlke, Beatrice Rath, Sascha Goebel, Jens Stehle, Stephan Reppenhagen, U. Schwemmer |
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| Rok vydání: | 2009 |
| Předmět: |
Adult
Male Shoulder medicine.medical_specialty Shoulder surgery medicine.medical_treatment Placebo-controlled study Patient satisfaction Double-Blind Method medicine Humans Infusion pump Brachial Plexus Ropivacaine Orthopedics and Sports Medicine Prospective Studies Anesthetics Local Aged Catheter insertion business.industry Analgesia Patient-Controlled Nerve Block General Medicine Middle Aged Amides Surgery Catheter Anesthesia Orthopedic surgery Female business medicine.drug |
| Zdroj: | Archives of Orthopaedic and Trauma Surgery. 130:533-540 |
| ISSN: | 1434-3916 0936-8051 |
| DOI: | 10.1007/s00402-009-0985-7 |
| Popis: | Interscalene brachial plexus block (ISB) is widely used as an adjuvant regional pain therapy in patients undergoing major shoulder surgery and has proved its effectiveness on postoperative pain reduction and opioid-sparing effect. This single-center, prospective, double-blind, randomized and placebo-controlled study was to compare the effectiveness of a single-shot and a patient-controlled catheter insertion ISB system after major open-shoulder surgeries. Seventy patients were entered to receive an ISB and a patient-controlled interscalene catheter. The catheter was inserted under ultrasound guidance. Patients were then assigned to receive one of two different postoperative infusions, either 0.2% ropivacaine (catheter group) or normal saline solution (single-shot group) via a disposable patient-controlled infusion pump. The study variables were amount of rescue medication, pain at rest and during physiotherapy, patient satisfaction and incidence of unwanted side effects. The ropivacaine group revealed significantly less consumption of rescue medication within the first 24 h after surgery. Incidence of side effects did not differ between the two groups. Based on our results, we recommend the use of interscalene plexus block in combination with a patient-controlled catheter system under ultrasound guidance only for the first 24 h after major open-shoulder surgery. |
| Databáze: | OpenAIRE |
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