Clinical observation on the analgesic efficiency of ropivacaine with continuous infiltration at subacromial bursa_West China Medical Journal

Authors：

ZHANG Jin ¹ , CHEN Hang ² ,  ZHANG Lan ¹

1. Department of Anesthesiology, Sichuan Provincial Orthopedics Hospital, Chengdu, Sichuan 610041, P. R. China;
2. Department of Upper Extremity, Sichuan Provincial Orthopedics Hospital, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

ZHANG Lan, Email: zlzxm@163.com

Keywords：

Rotator cuff injury; Subacromial bursa; Ropivacaine; Postoperative analgesia

DOI：

10.7507/1002-0179.201603091

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Objective To compare the analgesic efficiency and safety of subacromial bursa continued ropivacaine analgesia with patient-controlled intravenous analgesia for arthroscopic rotator cuff repair. Methods A total of 64 patients undergoing rotator cuff repair surgery between October 2013 and February 2015 were randomly divided into the subacromial bursa group (JFX group, 32 cases) and the patient-controlled intravenous analgesia group (JM group, 32 cases). At the end of surgery, a catheter was inserted into the subacromial bursa of the patients in JFX group under arthroscopic visualisation and fixed properly, and analgesia pump was connected after surgery; in JM group, analgesia pump was connected to the vein channel after surgery. The pain Visual Analogue Scale (VAS) (motion and rest) scores 1 hour and 12, 24, 48, 72 hours after surgery, adverse reactions, use of analgesic pump, number of additional analgesia and patients satisfaction were recorded. Results There were no differences between the two groups in the number of additional analgesia, patients satisfaction, additional use of antiemetic drugs, motion and rest VAS scores 1 hour and 12, 72 hours after surgery, and the incidence of moderate-severe pain (VAS≥4) at each time point (P>0.05). The motion and rest VAS scores 24, 48 hours after surgery in JFX group were lower than those in JM group, the analgesia times and the incidence of nausea and vomiting in JFX group were lower than those in JM group, and the differences were statistically significant (P<0.05). Conclusion Efficiency of subacromial bursa infiltration of ropivacaine sustained analgesic is slightly better than that of patient-controlled intravenous analgesia, with lower incidence of adverse reactions.

Citation： ZHANG Jin, CHEN Hang, ZHANG Lan. Clinical observation on the analgesic efficiency of ropivacaine with continuous infiltration at subacromial bursa. West China Medical Journal, 2017, 32(11): 1713-1716. doi: 10.7507/1002-0179.201603091 Copy

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11.	李挺, 曹親親, 李軍. 不同濃度羅哌卡因用于臂叢神經感覺與運動分離阻滯的效果. 中華麻醉學雜志, 2010, 30(12): 1462-1464.
12.	李挺, 馬劍峰, 劉若海, 等. 兩種濃度羅哌卡因用于自控肌問溝持續臂叢神經鎮痛的效果. 溫州醫學院院報, 2013, 43(4): 261-264.
13.	魏越, 郭向陽, 楊璐, 等. 連續肌間溝臂叢神經阻滯對關節鏡肩袖修復術患者圍手術期管理的影響. 中華醫學雜志, 2012, 92(33): 2327-2330.
14.	羅學宇, 陳偉, 王健. 舒芬太尼在骨科術后患者自控皮下鎮痛中的應用. 四川醫學, 2008, 29(8): 1012-1014.
15.	李露, 李秋軍, 周海濱, 等. 全身麻醉復合臂叢神經阻滯提高肩關節鏡術的麻醉質量. 國際麻醉學與復蘇雜志, 2013, 34(3): 230-233, 252.

1. 夏春明. 肩袖損傷的病因病理和發病機理. 醫學信息, 2000, 13: 196.
2. 唐三元, 徐永平, 鄭玉明. 肩袖損傷. 中華矯形外科雜志, 1999, 6(2): 140.
3. 劉玉杰, 盧世璧. 肩袖損傷的診斷和治療進展. 中華創傷雜志, 1998, 14(5): 340-342.
4. 邊文超, 張磊, 李進選, 等. 肩關節鏡圍手術期鎮痛新進展. 中國骨傷, 2015, 28(1): 85-89.
5. 趙東, 潘芳, 楊拔賢. 術后惡心嘔吐發生率與預防性用藥的意義. 臨床麻醉學雜志, 2006, 22(12): 912-914.
6. Little K, Pillai A, Fazzi U, et al. Local anaesthetic infusion with elastomeric pump after arthroscopic subacromial decompression. Ann R Coll Surg Engl, 2007, 89(4): 410-413.
7. Koltka K, Do?ruel B, Sentürk M, et al. Postoperative analgesia for arthroscopic rotator cuff surgery: a comparison between subacromial and interscalene levobupivacaine. Agri, 2011, 23(1): 7-12.
8. Coghlan JA, Forbes A, Bell SN, et al. Efficacy and safety of a subacromial continuous ropivacaine infusion for post-operative pain management following arthroscopic rotator cuff surgery: a protocol for a randomised double-blind placebo-controlled trial. BMC Musculoskelet Disord, 2008, 9: 56.
9. 馬浩南, 李恒林, 倪麗偉, 等. 右美托咪定對羅哌卡因腋路臂叢神經阻滯時效的影響. 臨床麻醉學雜志, 2012, 28(6): 531-533.
10. Hadzic A, Vloka JD, Hadzie A, et al. Intersealene brachial plexus block//Hadzic A, Vloka J. Peripheral nerve blocks: principles and practice. New York: McGraw-Hill, 2003: 109-122.
11. 李挺, 曹親親, 李軍. 不同濃度羅哌卡因用于臂叢神經感覺與運動分離阻滯的效果. 中華麻醉學雜志, 2010, 30(12): 1462-1464.
12. 李挺, 馬劍峰, 劉若海, 等. 兩種濃度羅哌卡因用于自控肌問溝持續臂叢神經鎮痛的效果. 溫州醫學院院報, 2013, 43(4): 261-264.
13. 魏越, 郭向陽, 楊璐, 等. 連續肌間溝臂叢神經阻滯對關節鏡肩袖修復術患者圍手術期管理的影響. 中華醫學雜志, 2012, 92(33): 2327-2330.
14. 羅學宇, 陳偉, 王健. 舒芬太尼在骨科術后患者自控皮下鎮痛中的應用. 四川醫學, 2008, 29(8): 1012-1014.
15. 李露, 李秋軍, 周海濱, 等. 全身麻醉復合臂叢神經阻滯提高肩關節鏡術的麻醉質量. 國際麻醉學與復蘇雜志, 2013, 34(3): 230-233, 252.

West China Medical Journal

Clinical observation on the analgesic efficiency of ropivacaine with continuous infiltration at subacromial bursa

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