• Anesthesiology · Jun 2002

    Randomized Controlled Trial Clinical Trial

    Continuous infraclavicular brachial plexus block for postoperative pain control at home: a randomized, double-blinded, placebo-controlled study.

    • Brian M Ilfeld, Timothy E Morey, and F Kayser Enneking.
    • Department of Anesthesiology and Orthopedics and Rehabilitation, University of Florida College of Medicine, Gainesville, Florida 32610, USA.
    • Anesthesiology. 2002 Jun 1;96(6):1297-304.

    BackgroundThis randomized, double-blinded, placebo-controlled study investigated the efficacy of patient-controlled regional analgesia using an infraclavicular brachial plexus perineural catheter and a portable infusion pump for outpatients undergoing moderately painful, upper extremity orthopedic surgery.MethodsPreoperatively, patients (n = 30) received an infraclavicular nerve block and perineural catheter. Postoperatively, patients were discharged home with oral narcotics and a portable infusion pump delivering study solution (0.2% ropivacaine or 0.9% saline) via the catheter for 3 days. Investigators and patients were blinded to random group assignment. Daily end points included pain scores at rest and with limb movement, narcotic use and side effects, sleep quality, patient satisfaction, and symptoms of catheter- or local anesthetic-related complications.ResultsRopivacaine (n = 15) infusion significantly reduced pain compared with saline (n = 15) infusion (P < 0.001). For example, the average pain with movement (scale, 0-10) on postoperative day 1 was 6.1 +/- 2.3 for the saline group versus 2.5 +/- 1.6 for the ropivacaine group (P < 0.001). Oral narcotic use and related side effects were significantly decreased in the ropivacaine group. For example, on postoperative day 1, mean tablet consumption was 5.5 +/- 2.4 and 1.7 +/- 1.6 for the saline and ropivacaine groups, respectively (P < 0.001). Sleep disturbance scores were 10-fold greater for saline administration than for ropivacaine infusion (P < 0.001). Overall satisfaction was significantly greater in the ropivacaine group. No catheter- or local anesthetic-related complications occurred.ConclusionAfter moderately painful orthopedic surgery of the upper extremity, ropivacaine infusion using a portable, mechanical pump and an infraclavicular brachial plexus perineural catheter at home decreased pain, sleep disturbances, narcotic use and related side effects, and improved overall satisfaction.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…