Effects of patient controlled axillary analgesia and continuous axillary infusion with 0.2% ropivacaine for postoperatif pain relief

Objective: In our propective, randomized study, analgesic efficacy and safety of 24 h continuous axillary infusion or patient controlled axillary analgesia of 2 mg/ml ropivacaine for postoperative pain relief were investigated in patients undergoing hand and forearm surgery.
Study Design: P re operatively, all patients received an axillary brachial plexus block (0.75% ropivacaine, 40 ml) and perineural catheter. Postoperatively, patients were randomly assigned one of two groups: patient controlled axillary analgesia with 0.2% ropivacaine (bolus: 0.25 mg/kg, lockout period: 60 min) or continuous axillary infusion of 0.2% ropivacaine at 0.25 mglkglh. Postoperative pain at rest was assessed by visual analog scale. Supplementary analgesic consumption and side effects were recorded.
Results: Postoperative analgesia quality and analgesic consumption were similar in both groups. Total consumption of local anesthetic during 24 h was 72.71±38.95 mg in patient controlled axillary group and 386.40±106.85 mg in continuous axillary infusion group (j-><0.0001). The degree of motor block was deeper in continuous group. No sign or symptom of systemic local anesthetic toxicity was observed.
Coclusion: This study demonstrates that, patient controlled axillary analgesia of 0.25 mg/kg, 0.2% ropivacaine provides adequate pain relief and earlier recovery of motor function with less local anesthetic volume during 24 h after surgery.

%0.2 ropivakainle hasta kontrollü aksiller analjezi ve sürekli aksiller infüzyonun postoperatif aðrý kontrolunda etkileri

Amaç: Prospektif, randomize çalýþmamýzda, el ve örýkol cerrahisi yapýlan hastalarda postoperatif aðrý kontrolunda 2 mg/ml ropivakainin 24 saat sürekli aksiller infüzyonu ve hasta kontrollü aksiller analjezide etkinliði ve güvenliði incelendi.
Gereç ve Yöntem: Operasyondan önce hütiin hastalara 40 ml %0.75’Iik ropivakainle aksiller brakial pleksus bloðu yapýldý ve perinöral kat et er takýldý. Operasyon sonrasý hastalar rasgele 2 gruptan birine dahil edildi: %0.2 ropivakainle hasta kontrollü aksiller analjezi (bolus: 0.25 nýg/kg, kilit süresi 60 dk.) veya sürekli aksiller infüzyon ( 0.25 mg/kg/saat). iþtira - hatteki postoperatif aðrý visiiel analog skala ile deðerlendirildi. Ek analjezik tüketimi ve yan etkiler kaydedildi.
Bulgular: Postoperatif analjezi kalitesi ve analjezik tüketimi her iki grupta da benzer bulundu. Postoperatif ilk 24 saat total lokal anestezik tüketimi hasta kontrollü analjezi grubunda 72.71 ±38.95 mg ve sürekli infüzyon grubunda 386,40± 106.85 mg olarak kaydedildi (p<0.0001). Motor blok derecesi sürekli infüzyon grubunda daha derindi. S istemik lokal anestezik toksisitesine ait hiçbir semptom ve bulgu gözlenmedi.
Sonuç: Bu çalýþma, cerrahi sonrasý ilk 24 saat daha az lokal anestezik volümü ile tam aðrý kontrolü ve motor fonksiyonlarda daha erken derlenme saðlayan hasta kontrollü aksiler analjezinin (%0.2 ropivakain, bolus 0.25 mg/kg) ortaya koymaktadýr.