title: [Optimal analgesic effect of continuous supraclavicular brachial plexus block with ropivacaine after shoulder surgery].
abstract: BACKGROUND
  Optimal dose of local anesthetics for supraclavicular brachial plexus block (BPB) is still unknown. We prospectively investigated the analgesic effect of ultrasound-guided continuous supraclavicular BPB with ropivacaine at different infusion rates.
  
  
  METHODS
  Thirty-nine patients scheduled to undergo shoulder surgery were randomly assigned to four groups; receiving no continuous BPB (control group, n = 10), BPB with 0.2% of ropivacaine at an infusion rate of 4 ml x hr(-1) (n = 12), BPB with 6 ml x hr(-1) (n = 12) or BPB with 8 ml x hr(-1) (n = 5). All patients were permitted to receive nonsteroidal anti-inflammatory drugs (NSAIDs) after surgery. Visual analogue scale (VAS) for postoperative pain was assessed and frequencies of the requirement of NSAIDs were recorded in each group.
  
  
  RESULTS
  The pain scores during 24 hours after surgery in the 6 ml x hr(-1) group (3-24 mm) were significantly lower than those in the 4 ml x hr(-1) group (4-42 mm) and control group (6-56 mm). Mean frequency of administrations of NSAIDs for 24 hours after surgery in the 6 ml x hr(-1) (0.8 +/- 0.8) group was significantly lower than that in the control group (1.7 +/- 1.0). Continuous administration in two cases in the 8 ml x hr(-1) group was discontinued due to leakage of local anesthetics and headache.
  
  
  CONCLUSIONS
  Continuous supraclavicular BPB with 0.2% ropivacaine at 6 ml x hr(-1) is effective for the pain management after shoulder surgery and is not an excess dose.
authors.affiliation: Department of Anesthesiology, Sapporo Medical University School of Medicine, Sapporo 060-8543.
authors.forename: Tomohisa
authors.initials: T
authors.lastname: Niiya
authors.forename: Masanori
authors.initials: M
authors.lastname: Yamauchi
authors.forename: Naomi
authors.initials: N
authors.lastname: Mizukami
authors.forename: Yukitoshi
authors.initials: Y
authors.lastname: Niiyama
authors.forename: Junpei
authors.initials: J
authors.lastname: Ohsone
authors.forename: Hironori
authors.initials: H
authors.lastname: Honma
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Kawamata
authors.forename: Michiaki
authors.initials: M
authors.lastname: Yamakage
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Hirose
mesh_terms: D000577:Amides / Q000494:pharmacology*; D000779:Anesthetics, Local / Q000494:pharmacology*; D001917:Brachial Plexus; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D011446:Prospective Studies; D000077212:Ropivacaine; D012785:Shoulder Joint / Q000601:surgery*
chemical_list: D000577:Amides; D000779:Anesthetics, Local; D000077212:Ropivacaine