The Effect of Preoperative Interscalene Block Using Low-Dose Mepivacaine on the Postoperative Pain after Shoulder Arthroscopic Surgery.
10.3344/kjp.2009.22.3.224
- Author:
Yong Hyun CHO
1
;
Seung Ho SHIN
;
Dong Hyun LEE
;
Eun Young YU
;
Myo Seop YOON
Author Information
1. Department of Anesthesiology and Pain Medicine, Seoul Sacred Heart Hospital, Seoul, Korea. anesthecho@naver.com
- Publication Type:Original Article
- Keywords:
interscalene brachial plexus block;
mepivacaine;
postoperative pain;
shoulder arthroscopic surgery
- MeSH:
Analgesia;
Analgesics, Opioid;
Anesthesia;
Arthroscopy;
Brachial Plexus;
Epinephrine;
Fentanyl;
Humans;
Mepivacaine;
Pain, Postoperative;
Shoulder
- From:The Korean Journal of Pain
2009;22(3):224-228
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Shoulder arthroscopic surgery is frequently associated with severe postoperative pain, which can be difficult to manage without the use of high-dose opioids. Although an interscalene brachial plexus block (ISBPB) can be used to provide anesthesia for shoulder arthroscopic surgery, its effect using low-dose mepivacaine on postoperative pain management has not been reported. We hypothesized that ISBPB using a low-dose mepivacaine can provide effective postoperative analgesia for shoulder arthroscopic surgery without the need for high-dose opioids and act as a significant motor or sensory block. METHODS: This study examined a total of 40 patients, who underwent shoulder arthroscopic surgery, and received ISBPB with 10 ml of normal saline (group NS; n = 20) or 10 ml of 1% mepivacaine with epinephrine 1:200,000 (group MC; n = 20). The block was performed preoperatively. The postoperative pain score, opioid consumption, and side effect were recorded. RESULTS: The visual analog scale scores were significantly lower in group MC than in group NS at 120 minutes after shoulder arthroscopic surgery (1.9 +/- 1.0 versus 4.0 +/- 1.4). Group MC showed significantly lower fentanyl consumption after shoulder arthroscoic surgery than group NS (27 +/- 32.6 versus 79 +/- 18.9microgram). The degree of motor and sensory block after surgery was minimal. CONCLUSIONS: ISBPB using low-dose mepivacaine reduced the level of postoperative pain and fentanyl consumption without significant side effects. ISBPB using low-dose mepivacaine is a useful analgesic technique for shoulder arthroscopic surgery.
