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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12.	李挺, 马剑峰, 刘若海, 等. 两种浓度罗哌卡因用于自控肌问沟持续臂丛神经镇痛的效果. 温州医学院院报, 2013, 43(4): 261-264.
13.	魏越, 郭向阳, 杨璐, 等. 连续肌间沟臂丛神经阻滞对关节镜肩袖修复术患者围手术期管理的影响. 中华医学杂志, 2012, 92(33): 2327-2330.
14.	罗学宇, 陈伟, 王健. 舒芬太尼在骨科术后患者自控皮下镇痛中的应用. 四川医学, 2008, 29(8): 1012-1014.
15.	李露, 李秋军, 周海滨, 等. 全身麻醉复合臂丛神经阻滞提高肩关节镜术的麻醉质量. 国际麻醉学与复苏杂志, 2013, 34(3): 230-233, 252.

1. 夏春明. 肩袖损伤的病因病理和发病机理. 医学信息, 2000, 13: 196.
2. 唐三元, 徐永平, 郑玉明. 肩袖损伤. 中华矫形外科杂志, 1999, 6(2): 140.
3. 刘玉杰, 卢世璧. 肩袖损伤的诊断和治疗进展. 中华创伤杂志, 1998, 14(5): 340-342.
4. 边文超, 张磊, 李进选, 等. 肩关节镜围手术期镇痛新进展. 中国骨伤, 2015, 28(1): 85-89.
5. 赵东, 潘芳, 杨拔贤. 术后恶心呕吐发生率与预防性用药的意义. 临床麻醉学杂志, 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, Doğruel 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. 马浩南, 李恒林, 倪丽伟, 等. 右美托咪定对罗哌卡因腋路臂丛神经阻滞时效的影响. 临床麻醉学杂志, 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, 曹亲亲, 李军. 不同浓度罗哌卡因用于臂丛神经感觉与运动分离阻滞的效果. 中华麻醉学杂志, 2010, 30(12): 1462-1464.
12. 李挺, 马剑峰, 刘若海, 等. 两种浓度罗哌卡因用于自控肌问沟持续臂丛神经镇痛的效果. 温州医学院院报, 2013, 43(4): 261-264.
13. 魏越, 郭向阳, 杨璐, 等. 连续肌间沟臂丛神经阻滞对关节镜肩袖修复术患者围手术期管理的影响. 中华医学杂志, 2012, 92(33): 2327-2330.
14. 罗学宇, 陈伟, 王健. 舒芬太尼在骨科术后患者自控皮下镇痛中的应用. 四川医学, 2008, 29(8): 1012-1014.
15. 李露, 李秋军, 周海滨, 等. 全身麻醉复合臂丛神经阻滞提高肩关节镜术的麻醉质量. 国际麻醉学与复苏杂志, 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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