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Comparison between two different concentrations of a fixed dose of ropivacaine in interscalene brachial plexus block for pain management after arthroscopic shoulder surgery: a randomized clinical trial

대한마취과학회지 2021년 74권 3호 p.226 ~ 233
이승철, 정준호, 정성엽, 김성완, 정찬종, 최소론, 김정호, 박상융,
소속 상세정보
이승철 ( Lee Seung-Cheol ) - Dong-A University College of Medicine Department of Anesthesiology and Pain Medicine
정준호 ( Jeong Joon-Ho ) - Dong-A University College of Medicine Department of Anesthesiology and Pain Medicine
정성엽 ( Jeong Seong-Yeop ) - Dong-A University College of Medicine Department of Anesthesiology and Pain Medicine
김성완 ( Kim Sung-Wan ) - Dong-A University College of Medicine Department of Anesthesiology and Pain Medicine
정찬종 ( Chung Chan-Jong ) - Dong-A University College of Medicine Department of Anesthesiology and Pain Medicine
최소론 ( Choi So-Ron ) - Dong-A University College of Medicine Department of Anesthesiology and Pain Medicine
김정호 ( Kim Jeong-Ho ) - Dong-A University College of Medicine Department of Anesthesiology and Pain Medicine
박상융 ( Park Sang-Yoong ) - Dong-A University College of Medicine Department of Anesthesiology and Pain Medicine

Abstract


Background: Only a few studies have evaluated the differences between varying concentrations of a fixed dose of local anesthetics. This study was conducted to compare the effects of two different concentrations of a fixed dose of ropivacaine used in ultrasound-guided interscalene brachial plexus block.

Methods: This prospective, randomized, double-blind study included 62 patients who underwent arthroscopic surgery under general anesthesia. The patients were randomly assigned to receive ultrasound-guided interscalene block with 75 mg of ropivacaine at one of two concentrations: 0.75% (10 ml; Group C) or 0.375% (20 ml; Group V). Time to onset of sensory blockade, degree of blockade, pulmonary function changes, analgesic duration of the interscalene block, postoperative opioid requirement within 24 h, postoperative pain scores, satisfaction, and incidence of complications were recorded.

Results: Although the time to onset of sensory blockade was shorter for Group C (P = 0.015), successful blockade was achieved at 30 min after the interscalene block in both groups. The analgesic duration of the interscalene block was not significantly different between the groups. The amount of opioid used within 24 h after surgery was significantly reduced for Group V compared with Group C (P = 0.016). The rest of the parameters did not show any significant differences between the two groups.

Conclusions: Compared with 10 ml of 0.75% ropivacaine, interscalene block with 20 ml of 0.375% ropivacaine could be effective for the reduction of postoperative opioid requirement within 24 h after surgery despite it might not prolong the analgesic duration.

키워드

Brachial plexus; Pain management; Patient-controlled analgesia; Postoperative pain; Shoulder pain; Ultrasonography

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