Comparison of interscalene brachial plexus block and superior trunk block with ropivacaine in shoulder arthroscopic surgery
10.12206/j.issn.1006-0111.202105099
- VernacularTitle:罗哌卡因用于肌间沟与臂丛上干阻滞在肩关节镜手术的临床效果对比
- Author:
Yangyang ZHOU
1
;
Xiaodi YAN
1
;
Jinxiang ZHANG
1
;
Peng DING
2
,
3
;
Liye YANG
1
;
Yonghua LI
1
Author Information
1. Department of Anesthesiology, Second Affiliated Hospital of Naval Medical University, Shanghai 200003, China.
2. Department of Anesthesiology, Second Affiliated Hospital of Naval Medical University, Shanghai 200003, China
3. Department of Anesthesiology, No.983 Hospital of PLA, Tianjin 300142, China.
- Keywords:
superior trunk block;
hemidiaphragmatic paresis;
interscalene brachial plexus block;
arthroscopic shoulder surgery;
ropivacaine
- From:
Journal of Pharmaceutical Practice
2021;39(6):561-565
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the clinical effects of interscalene brachial plexus block and superior trunk block in arthroscopic shoulder surgery with 0.25% ropivacaine. Methods 46 patients undergoing shoulder arthroscopy surgery were included and randomly divided into group ISB (n=23) and group ST (n=23). Patients in group ISB received 10 ml 0.25% ropivacaine on the lateral side of C5 and C6. Patients in group ST were treated with 5 ml 0.25% ropivacaine on both sides of the superior trunk of brachial plexus. The diaphragmatic excursion, Numerical Rating Scale(NRS), duration of the block, handgrip strength were recorded at different time. Results No statistical difference was detected between the two groups in the reduction of diaphragmatic excursion within 30 min after block (P>0.05). Compared with ISB patients, ST patients had significantly less diaphragmatic excursion at 3 h after block（P<0.05). 30 minutes after block, 8.7% patients in ISB group reached complete HDP and 52.2% patients reached partial HDP. At the same time, no complete HDP and 26.1% partial HDP were detected in ST group. 3 hours after block, patients in ST group had lower complete HDP rate (0.0% vs 17.4%) and lower partial HDP rate (39.1% vs 65.2%) than patients in ISB group. At 30 minutes and 3 h after block, the reduction of grip strength in ST group was significantly lower than that in ISB group (P<0.001). ST group had lower NRS than ISB group (P<0.05). The average block time in ISB group (8.3±1.97 )h was significantly lower than that in ST group (10.9±1.26)h (P<0.01). Conclusion Superior trunk block with 10 ml 0.25% ropivacaine is superior compared to interscalene brachial plexus block in occurrence of HDP, decrease of grip strength, postoperative pain and block duration.
