[Bupivacaine for continuous interscalene brachial plexus analgesia after shoulder surgery].
OBJECTIVE
This study evaluates clinical efficacy of continuous interscalene brachial plexus block with bupivacaine 0.15% for postoperative analgesia after shoulder surgery.


METHODS
Eighty patients, scheduled for elective shoulder surgery, were included in this study. All patients received an interscalene block before surgery. A perineural catheter was then introduced for continuous brachial plexus analgesia. Patients were prospectively randomized in a double-blinded fashion to receive either bupivacaine 0.15% or placebo postoperative infusion through an interscalene catheter. Pain was assessed with a visual analog scale at rest and also in motion. Duration of surgery and surgery type, satisfaction scores, supplemental analgesia, side effects, circulatory and respiratory parameters were recorded.


RESULTS
The bupivacaine group showed less pain at rest and in motion than the placebo group (p<0.0001), except 4 and 6 h after the brachial plexus block; a requirement for supplemental analgesia was also lower. Side effects (except weakness in the arm, which was more frequent in bupivacaine group), circulatory and respiratory parameters were comparable in both groups. Satisfaction scores were higher in bupivacaine group.


CONCLUSIONS
Continuous interscalene brachial plexus analgesia is a reliable and effective method of providing postoperative pain relief after shoulder surgery and is superior to the systemic analgesia.
Tamosiūnas
Ramūnas
R
Clinic of Anesthesiology, Kaunas University of Medicine Hospital, Eiveniu 2, 50010 Kaunas, Lithuania. ramunas@kmu.lt
Gudas
Rimtautas
R
Karbonskiene
Aurika
A
Marchertiene
Irena
I
D000293:Adolescent; D000328:Adult; D000368:Aged; D000700:Analgesics / Q000008:administration & dosage / Q000627:therapeutic use; D000779:Anesthetics, Local / Q000008:administration & dosage* / Q000009:adverse effects; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000627:therapeutic use; D001917:Brachial Plexus; D002045:Bupivacaine / Q000008:administration & dosage* / Q000009:adverse effects; D000068579:Celecoxib; D016009:Chi-Square Distribution; D003627:Data Interpretation, Statistical; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular; D008297:Male; D008875:Middle Aged; D009407:Nerve Block; D010149:Postoperative Pain / Q000175:diagnosis / Q000188:drug therapy / Q000517:prevention & control*; D017060:Patient Satisfaction; D010919:Placebos; D011446:Prospective Studies; D011720:Pyrazoles; D012785:Shoulder Joint / Q000601:surgery*; D013449:Sulfonamides / Q000008:administration & dosage / Q000627:therapeutic use; D013997:Time Factors
D000700:Analgesics; D000779:Anesthetics, Local; D000894:Anti-Inflammatory Agents, Non-Steroidal; D010919:Placebos; D011720:Pyrazoles; D013449:Sulfonamides; D000068579:Celecoxib; D002045:Bupivacaine