PATIENT-CONTROLLED INTERSCALENE ANALGESIA WITH ROPIVACAINE AFTER MAJOR SHOULDER SURGERY - PCIA VS PCA

We have compared the efficacy of patient-controlled interscalene analg esia (PCIA) using ropivacaine with patient-controlled analgesia (PCA) using nicomorphine in 60 patients (n=30 in each group), in a prospecti ve, randomized study. In both groups, all patients received interscale ne block with 0.75% ropivacaine before induction of anaesthesia. Six h ours after interscalene block, patients in group PCIA received continu ous infusion of 0.2% ropivacaine at a rate of 5 mi h(-1) with a bolus dose of 3 or 4 mi and a lockout time of 20 min; patients in group PCA received continuous infusion of nicomorphine 0.5 mg h(-1) and a bolus dose of 2 or 3 mg with a lockout time of 20 min. Control of pain was s ignificantly better from 12 to 48 h after operation (except at 42 h) i n group PCIA. Nausea and pruritus occurred significantly more frequent ly in group PCA. Patient satisfaction was greater in group PCIA. We co nclude that the use of 0.2% ropivacaine using PCIA was an efficient wa y of managing pain after major shoulder surgery and com pa red favoura bly with PCA nicomorphine in terms of pain relief, side effects and pa tient satisfaction.