Continuous infraclavicular brachial plexus block for postoperative pain control at home: A randomized, double-blinded, placebo-controlled study
This 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. Pr...
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| Veröffentlicht in: | Anesthesiology (Philadelphia) 2002-06, Vol.96 (6), p.1297-1304 |
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| creator | ILFELD, Brian M MOREY, Timothy E ENNEKING, F. Kayser |
| description | This 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.
Preoperatively, 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.
Ropivacaine (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.
After 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. |
| doi_str_mv | 10.1097/00000542-200206000-00006 |
| format | Article |
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Preoperatively, 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.
Ropivacaine (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.
After 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.</description><identifier>ISSN: 0003-3022</identifier><identifier>EISSN: 1528-1175</identifier><identifier>DOI: 10.1097/00000542-200206000-00006</identifier><identifier>PMID: 12170039</identifier><identifier>CODEN: ANESAV</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott</publisher><subject>Adult ; Aged ; Amides - adverse effects ; Amides - therapeutic use ; Analgesia, Patient-Controlled - methods ; Anesthesia ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Brachial Plexus ; Catheters, Indwelling ; Double-Blind Method ; Female ; Humans ; Local anesthesia. Pain (treatment) ; Male ; Medical sciences ; Middle Aged ; Nerve Block - adverse effects ; Nerve Block - methods ; Pain, Postoperative - therapy ; Prospective Studies ; Ropivacaine</subject><ispartof>Anesthesiology (Philadelphia), 2002-06, Vol.96 (6), p.1297-1304</ispartof><rights>2002 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=13698409$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12170039$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>ILFELD, Brian M</creatorcontrib><creatorcontrib>MOREY, Timothy E</creatorcontrib><creatorcontrib>ENNEKING, F. Kayser</creatorcontrib><title>Continuous infraclavicular brachial plexus block for postoperative pain control at home: A randomized, double-blinded, placebo-controlled study</title><title>Anesthesiology (Philadelphia)</title><addtitle>Anesthesiology</addtitle><description>This 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.
Preoperatively, 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.
Ropivacaine (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.
After 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.</description><subject>Adult</subject><subject>Aged</subject><subject>Amides - adverse effects</subject><subject>Amides - therapeutic use</subject><subject>Analgesia, Patient-Controlled - methods</subject><subject>Anesthesia</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Brachial Plexus</subject><subject>Catheters, Indwelling</subject><subject>Double-Blind Method</subject><subject>Female</subject><subject>Humans</subject><subject>Local anesthesia. Pain (treatment)</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Nerve Block - adverse effects</subject><subject>Nerve Block - methods</subject><subject>Pain, Postoperative - therapy</subject><subject>Prospective Studies</subject><subject>Ropivacaine</subject><issn>0003-3022</issn><issn>1528-1175</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2002</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkMtOwzAQRS0EoqXwC8gbdhj8iJOYXVXxkiqxgXU18YMa3DiKE0T5CX4ZVxQxm9G5984sLkKY0StGVXVNdyMLTjilnJYZyE4pD9CUSV4Txip5iKZZEkRQzifoJKW3jJUU9TGaMM6q7Kkp-l7EdvDtGMeEfet60AE-vB4D9LjJtPYQcBfsZ_abEPU7drHHXUxD7GwPg_-wuAPfYp3_9DFgGPA6buwNnuMeWhM3_suaS2zi2ARLmuBbs-MugLZNJPuzYA1Ow2i2p-jIQUj2bL9n6OXu9nnxQJZP94-L-ZK88pIPxDHHuCpLxy1QJ5h1plZKSuDUgapLpQrNmRGqYqIQrioasLI20hglKq5AzND5799ubDbWrLreb6Dfrv6ayYGLfQCShpCbabVP_zlRqrqgSvwAd5l2_Q</recordid><startdate>20020601</startdate><enddate>20020601</enddate><creator>ILFELD, Brian M</creator><creator>MOREY, Timothy E</creator><creator>ENNEKING, F. Kayser</creator><general>Lippincott</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope></search><sort><creationdate>20020601</creationdate><title>Continuous infraclavicular brachial plexus block for postoperative pain control at home: A randomized, double-blinded, placebo-controlled study</title><author>ILFELD, Brian M ; MOREY, Timothy E ; ENNEKING, F. Kayser</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-g262t-f1f12966f2ea0f31efd89955a20fa986994c21d3971343f74bae58d5dd93729a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2002</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Amides - adverse effects</topic><topic>Amides - therapeutic use</topic><topic>Analgesia, Patient-Controlled - methods</topic><topic>Anesthesia</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>Brachial Plexus</topic><topic>Catheters, Indwelling</topic><topic>Double-Blind Method</topic><topic>Female</topic><topic>Humans</topic><topic>Local anesthesia. Pain (treatment)</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Nerve Block - adverse effects</topic><topic>Nerve Block - methods</topic><topic>Pain, Postoperative - therapy</topic><topic>Prospective Studies</topic><topic>Ropivacaine</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>ILFELD, Brian M</creatorcontrib><creatorcontrib>MOREY, Timothy E</creatorcontrib><creatorcontrib>ENNEKING, F. Kayser</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><jtitle>Anesthesiology (Philadelphia)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>ILFELD, Brian M</au><au>MOREY, Timothy E</au><au>ENNEKING, F. Kayser</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Continuous infraclavicular brachial plexus block for postoperative pain control at home: A randomized, double-blinded, placebo-controlled study</atitle><jtitle>Anesthesiology (Philadelphia)</jtitle><addtitle>Anesthesiology</addtitle><date>2002-06-01</date><risdate>2002</risdate><volume>96</volume><issue>6</issue><spage>1297</spage><epage>1304</epage><pages>1297-1304</pages><issn>0003-3022</issn><eissn>1528-1175</eissn><coden>ANESAV</coden><abstract>This 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.
Preoperatively, 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.
Ropivacaine (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.
After 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.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott</pub><pmid>12170039</pmid><doi>10.1097/00000542-200206000-00006</doi><tpages>8</tpages></addata></record> |
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| subjects | Adult Aged Amides - adverse effects Amides - therapeutic use Analgesia, Patient-Controlled - methods Anesthesia Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Brachial Plexus Catheters, Indwelling Double-Blind Method Female Humans Local anesthesia. Pain (treatment) Male Medical sciences Middle Aged Nerve Block - adverse effects Nerve Block - methods Pain, Postoperative - therapy Prospective Studies Ropivacaine |
| title | Continuous infraclavicular brachial plexus block for postoperative pain control at home: A randomized, double-blinded, placebo-controlled study |
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