open access

Vol 49, No 3 (2017)
Original and clinical articles
Published online: 2017-06-22
Submitted: 2017-01-31
Accepted: 2017-06-16
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Randomised controlled trial of analgesic effectiveness of three different techniques of single-shot interscalene brachial plexus block using 20 mL of 0.5% ropivacaine for shoulder arthroscopy

Michał Jan Stasiowski, Michał Kolny, Marek Zuber, Radosław Marciniak, Ewa Chabierska, Przemysław Jałowiecki, Aleksandra Pluta, Bartłomiej Możdżyński
DOI: 10.5603/AIT.a2017.0031
·
Pubmed: 28712103
·
Anaesthesiol Intensive Ther 2017;49(3):215-221.

open access

Vol 49, No 3 (2017)
Original and clinical articles
Published online: 2017-06-22
Submitted: 2017-01-31
Accepted: 2017-06-16

Abstract

BACKGROUND: Shoulder arthroscopic procedures impose a challenge to anaesthesiologists in terms of postoperative analgesia. Proper pain management after arthroscopic procedures improves patient satisfaction and facilitates early rehabilitation.

METHODS: We performed a randomized, prospective clinical study to assess the influence of anthropometric parameters and IBPB technique on the quality of postoperative analgesia. A total of 106 randomly selected patients of ASA I–III status scheduled for elective shoulder arthroscopy. Reasons for exclusion were neurological deficit in the upper arm, allergies to amide-type local anesthetics, coagulopathy, and pregnancy.The patients received 20 mL of 0.5% ropivacaine for an ultrasound-guided interscalene brachial plexus block (IBPB) (group U), peripheral nerve stimulation (PNS)-confirmed IBPB (group N), or ultrasound-guided, PNS-confirmed IBPB (dual guidance; group NU).

RESULTS: We observed that the three groups did not differ in mean time of sensory and motor block terminations. In individual cases in each group, sensory block lasted up to 890–990 minutes, providing satisfactory long lasting postoperative analgesia in patients receiving IBPB. We observed a negative correlation between body mass index and termination of motor block (P = 0.037, Pearson’s correlation coefficient) and a positive correlation between age and termination of sensory block (P = 0.0314, Pearson’s correlation coefficient) in group U compared to the other two groups. We found a positive correlation between male gender and termination of motor block (P = 0.0487, Pearson’s correlation coefficient) in group N compared to the other two groups.

CONCLUSION: In our study, patients received satisfactory analgesia in the postoperative period regardless of technique used, age, gender, or potentially uncommon anthropometry.

Abstract

BACKGROUND: Shoulder arthroscopic procedures impose a challenge to anaesthesiologists in terms of postoperative analgesia. Proper pain management after arthroscopic procedures improves patient satisfaction and facilitates early rehabilitation.

METHODS: We performed a randomized, prospective clinical study to assess the influence of anthropometric parameters and IBPB technique on the quality of postoperative analgesia. A total of 106 randomly selected patients of ASA I–III status scheduled for elective shoulder arthroscopy. Reasons for exclusion were neurological deficit in the upper arm, allergies to amide-type local anesthetics, coagulopathy, and pregnancy.The patients received 20 mL of 0.5% ropivacaine for an ultrasound-guided interscalene brachial plexus block (IBPB) (group U), peripheral nerve stimulation (PNS)-confirmed IBPB (group N), or ultrasound-guided, PNS-confirmed IBPB (dual guidance; group NU).

RESULTS: We observed that the three groups did not differ in mean time of sensory and motor block terminations. In individual cases in each group, sensory block lasted up to 890–990 minutes, providing satisfactory long lasting postoperative analgesia in patients receiving IBPB. We observed a negative correlation between body mass index and termination of motor block (P = 0.037, Pearson’s correlation coefficient) and a positive correlation between age and termination of sensory block (P = 0.0314, Pearson’s correlation coefficient) in group U compared to the other two groups. We found a positive correlation between male gender and termination of motor block (P = 0.0487, Pearson’s correlation coefficient) in group N compared to the other two groups.

CONCLUSION: In our study, patients received satisfactory analgesia in the postoperative period regardless of technique used, age, gender, or potentially uncommon anthropometry.

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Keywords

interscalene brachial plexus block, interscalene brachial plexus, local anesthetic, Lovett’s Rating Scale, ultrasound, peripheral nerve stimulator, body mass index, regional anesthesia, general anaesthesia

About this article
Title

Randomised controlled trial of analgesic effectiveness of three different techniques of single-shot interscalene brachial plexus block using 20 mL of 0.5% ropivacaine for shoulder arthroscopy

Journal

Anaesthesiology Intensive Therapy

Issue

Vol 49, No 3 (2017)

Pages

215-221

Published online

2017-06-22

DOI

10.5603/AIT.a2017.0031

Pubmed

28712103

Bibliographic record

Anaesthesiol Intensive Ther 2017;49(3):215-221.

Keywords

interscalene brachial plexus block
interscalene brachial plexus
local anesthetic
Lovett’s Rating Scale
ultrasound
peripheral nerve stimulator
body mass index
regional anesthesia
general anaesthesia

Authors

Michał Jan Stasiowski
Michał Kolny
Marek Zuber
Radosław Marciniak
Ewa Chabierska
Przemysław Jałowiecki
Aleksandra Pluta
Bartłomiej Możdżyński

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