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. 2010 Jul;59(1):27-33.
doi: 10.4097/kjae.2010.59.1.27. Epub 2010 Jul 21.

A clinical comparison of continuous interscalene brachial plexus block with different basal infusion rates of 0.2% ropivacaine for shoulder surgery

Chun Woo Yang  1 , Sung Mee Jung, Hee Uk Kwon, Choon-Kyu Cho, Jin Woong Yi, Chul Woung Kim, Jong-Kwon Jung, Young Mi An
Affiliations

A clinical comparison of continuous interscalene brachial plexus block with different basal infusion rates of 0.2% ropivacaine for shoulder surgery

Chun Woo Yang et al. Korean J Anesthesiol. 2010 Jul.

Abstract

Background: A continuous interscalene brachial plexus block is a highly effective postoperative analgesic modality after shoulder surgery. However, there is no consensus regarding the optimal basal infusion rate of ropivacaine for a continuous interscalene brachial plexus block. A prospective, double blind study was performed to compare two different basal rates of 0.2% ropivacaine for a continuous interscalene brachial plexus block after shoulder surgery.

Methods: Sixty-two patients receiving shoulder surgery under an interscalene brachial plexus block were included. The continuous interscalene brachial plexus block was performed using a modified lateral technique with 30 ml of 0.5% ropivacaine. Surgery was carried out under an interscalene brachial plexus block or general anesthesia. After surgery, the patients were divided randomly into two groups containing 32 each. During the first 48 h after surgery, groups R8 and R6 received a continuous infusion of 0.2% ropivacaine at 8 ml/h and 6 ml/h, respectively. The pain scores at rest and on movement, supplemental analgesia, motor block, adverse events and patient's satisfaction were recorded.

Results: The pain scores, supplemental analgesia, motor block, adverse events and patient's satisfaction were similar in the two groups.

Conclusions: When providing continuous interscalene brachial plexus block after shoulder surgery, 0.2% ropivacaine at a basal rate of 8 ml/h or 6 ml/h produces similar clinical efficacy. Therefore, decreasing the basal rate of CISB is more appropriate considering the toxicity of local anesthetics.

Keywords: Continuous interscalene block; Ropivacaine; Shoulder surgery.

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Figures

Fig. 1
Fig. 1
Median and range for the visual analog scale pain scores at rest (0 mm = no pain to 10 mm = worst pain imaginable). Group R8: continuous interscalene brachial plexus block with 0.2% ropivacaine at a rate of 8 ml/h, Group R6: continuous interscalene brachial plexus block with 0.2% ropivacaine at a rate of 6 ml/h. PACU: postanesthetic care unit.
Fig. 2
Fig. 2
Median and range for the visual analog scale pain scores during passive movement of the shoulder (0 cm = no pain to 10 cm = worst pain imaginable). Group R8: continuous interscalene brachial plexus block with 0.2% ropivacaine at a rate of 8 ml/h, Group R6: continuous interscalene brachial plexus block with 0.2% ropivacaine at a rate of 6 ml/h. PACU: postanesthetic care unit.
Fig. 3
Fig. 3
Local anesthetic consumption. Group R8: continuous interscalene brachial plexus block with 0.2% ropivacaine at a rate of 8 ml/h, Group R6: continuous interscalene brachial plexus block with 0.2% ropivacaine at a rate of 6 ml/h. PACU: postanesthetic care unit.
Fig. 4
Fig. 4
Progression of the motor block in the operated limb during 48 h of CISB. Group R8: continuous interscalene brachial plexus block with 0.2% ropivacaine at a rate of 8 ml/h, Group R6: continuous interscalene brachial plexus block with 0.2% ropivacaine at a rate of 6 ml/h.
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