<b>Background:</b> One common method of pain control for total shoulder arthroplasty is long-duration delivery of local anesthetic via interscalene brachial plexus block (ISB) with a continuous catheter. A...<b>Background:</b> One common method of pain control for total shoulder arthroplasty is long-duration delivery of local anesthetic via interscalene brachial plexus block (ISB) with a continuous catheter. Alternatively, liposomal bupivacaine has also been administered as an ISB as a means to prolong the analgesic effect. This study was completed to measure the non-inferiority of single-injection ISB with liposomal bupivacaine compared with ISB continuous catheter for total shoulder arthroplasty. <b>Methods:</b> We performed a retrospective chart review of patients who underwent total shoulder arthroplasty using either an ISB continuous catheter or a single injection ISB with liposomal bupivacaine for post operative analgesia. The primary goal of this study was to determine if single-injection with liposomal bupivacaine conferred non-inferior pain scores compared to the continuous catheter. Secondary outcomes evaluated oxygen saturation as a measure of hemidiaphragmatic paresis, post operative opioid requirements, and difference in cost. <b>Results:</b> We identified 333 patients for the study: 126 received continuous catheter and 207 received single-injection with liposomal bupivacaine. The median length of stay was 1 day. Pain scores for those treated with single-injection with liposomal bupivacaine were non-inferior to pain scores of those treated with the continuous catheter on post-op days 0, 1 and 2. Pain scores were lower for single-injection with liposomal bupivacaine patients on days 3 and 4, however they did not reach statistical significance. There was no significant difference in oxygen saturation between the two groups. Both groups had similar daily morphine milligram equivalent requirements. Liposomal bupivacaine ISB was also found to be less expensive. <b>Conclusion:</b> Single-injection ISB with liposomal bupivacaine provides non-inferior analgesia at a reduced cost compared with continuous catheter ISB for total shoulder arthroplasty.展开更多
目的研究超声引导下不同成分局麻药腹横筋膜神经阻滞在剖宫产术后的镇痛效果的差异。方法选择2019年1~12月择期腰麻下行剖宫产手术患者90例,术毕分别给予0.33%罗哌卡因(A组)、0.125%布比卡因(B组)、0.33%罗哌卡因复合2μg/kg右美托咪定(...目的研究超声引导下不同成分局麻药腹横筋膜神经阻滞在剖宫产术后的镇痛效果的差异。方法选择2019年1~12月择期腰麻下行剖宫产手术患者90例,术毕分别给予0.33%罗哌卡因(A组)、0.125%布比卡因(B组)、0.33%罗哌卡因复合2μg/kg右美托咪定(C组)进行超声引导下双侧腹横筋膜阻滞(每侧15 ml),每组30例。分别记录3组患者术后镇痛药物用量、腹横筋膜神经阻滞镇痛持续时间、术后不同时间视觉模拟评分。结果3组患者术后24 h曲马多用量差异有统计学意义(P=0.001)。B组术后24 h曲马多用量高于A、C组,差异有统计学意义(P<0.05),A、C组比较,差异无统计学意义(P>0.05)。B组术后4、8、16、24 h VAS评分高于A、C组,差异有统计学意义(P<0.05),B组术后12 h VAS评分高于C组,差异有统计学意义(P<0.05)。A、C组比较,差异无统计学意义(P>0.05),术后12、16 h A、C组,A、B组比较,差异无统计学意义(P>0.05)。B组腹横筋膜阻滞时间短于A、C组,差异有统计学意义(P<0.05)。A、C组比较,差异无统计学意义(P>0.05)。结论剖宫产手术术后采用超声引导下罗哌卡因复合右美托咪定腹横筋膜神经阻滞可有效缓解术后疼痛感,减少术后镇痛药用量,延长神经阻滞作用时间,是一种安全有效的术后镇痛方式。展开更多
文摘<b>Background:</b> One common method of pain control for total shoulder arthroplasty is long-duration delivery of local anesthetic via interscalene brachial plexus block (ISB) with a continuous catheter. Alternatively, liposomal bupivacaine has also been administered as an ISB as a means to prolong the analgesic effect. This study was completed to measure the non-inferiority of single-injection ISB with liposomal bupivacaine compared with ISB continuous catheter for total shoulder arthroplasty. <b>Methods:</b> We performed a retrospective chart review of patients who underwent total shoulder arthroplasty using either an ISB continuous catheter or a single injection ISB with liposomal bupivacaine for post operative analgesia. The primary goal of this study was to determine if single-injection with liposomal bupivacaine conferred non-inferior pain scores compared to the continuous catheter. Secondary outcomes evaluated oxygen saturation as a measure of hemidiaphragmatic paresis, post operative opioid requirements, and difference in cost. <b>Results:</b> We identified 333 patients for the study: 126 received continuous catheter and 207 received single-injection with liposomal bupivacaine. The median length of stay was 1 day. Pain scores for those treated with single-injection with liposomal bupivacaine were non-inferior to pain scores of those treated with the continuous catheter on post-op days 0, 1 and 2. Pain scores were lower for single-injection with liposomal bupivacaine patients on days 3 and 4, however they did not reach statistical significance. There was no significant difference in oxygen saturation between the two groups. Both groups had similar daily morphine milligram equivalent requirements. Liposomal bupivacaine ISB was also found to be less expensive. <b>Conclusion:</b> Single-injection ISB with liposomal bupivacaine provides non-inferior analgesia at a reduced cost compared with continuous catheter ISB for total shoulder arthroplasty.
文摘目的研究超声引导下不同成分局麻药腹横筋膜神经阻滞在剖宫产术后的镇痛效果的差异。方法选择2019年1~12月择期腰麻下行剖宫产手术患者90例,术毕分别给予0.33%罗哌卡因(A组)、0.125%布比卡因(B组)、0.33%罗哌卡因复合2μg/kg右美托咪定(C组)进行超声引导下双侧腹横筋膜阻滞(每侧15 ml),每组30例。分别记录3组患者术后镇痛药物用量、腹横筋膜神经阻滞镇痛持续时间、术后不同时间视觉模拟评分。结果3组患者术后24 h曲马多用量差异有统计学意义(P=0.001)。B组术后24 h曲马多用量高于A、C组,差异有统计学意义(P<0.05),A、C组比较,差异无统计学意义(P>0.05)。B组术后4、8、16、24 h VAS评分高于A、C组,差异有统计学意义(P<0.05),B组术后12 h VAS评分高于C组,差异有统计学意义(P<0.05)。A、C组比较,差异无统计学意义(P>0.05),术后12、16 h A、C组,A、B组比较,差异无统计学意义(P>0.05)。B组腹横筋膜阻滞时间短于A、C组,差异有统计学意义(P<0.05)。A、C组比较,差异无统计学意义(P>0.05)。结论剖宫产手术术后采用超声引导下罗哌卡因复合右美托咪定腹横筋膜神经阻滞可有效缓解术后疼痛感,减少术后镇痛药用量,延长神经阻滞作用时间,是一种安全有效的术后镇痛方式。
