Sm. Klein et al., Interscalene brachial plexus block with a continuous catheter insertion system and a disposable infusion pump, ANESTH ANAL, 91(6), 2000, pp. 1473-1478
Citations number
13
Categorie Soggetti
Aneshtesia & Intensive Care","Medical Research Diagnosis & Treatment
Continuous interscalene brachial plexus blockade traditionally requires a h
ospital stay for local anesthetic infusion, and achieving consistent cathet
er insertion may be difficult. Incorporating long-acting pain relief from a
continuous peripheral nerve block, with a reliable method of catheter inse
rtion, and a self-contained infusion system would be a valuable asset for s
hort-stay care. We compared the efficacy of single injection interscalene b
rachial plexus blockade to a continuous peripheral nerve block, with an ins
ulated Tuohy system and a disposable infusion pump. Forty adult patients sc
heduled for open rotator cuff repair were entered in this randomized, doubl
e-blinded, placebo-controlled study. Patients received an interscalene brac
hial plexus blockade and a continuous peripheral nerve catheter as their pr
imary anesthetic and then, were assigned to receive one of two different po
stoperative infusions: either 0.2% ropivacaine at 10 mL/h via a disposable
infusion pump or normal saline at 10 mL/h via a disposable infusion pump (n
= 18-20 per group). Visual analog pain scores and postoperative morphine c
onsumption were measured for 24 h. The ropivacaine group showed less pain t
han the placebo group (P = 0.0001) between 12 and 24 h after the initial in
jection of local anesthetic. In addition, initial interscalene blockade was
successful in all patients and all redosed catheters were functional after
24 h with the continuous catheter insertion system. We conclude that it is
possible to achieve a high rate of successful catheter placement and analg
esia by using the continuous catheter insertion system and a disposable inf
usion pump in the ambulatory setting. This method of analgesia may offer im
proved pain relief after outpatient rotator cuff repair.