견관절경 수술시 사각근간 상완신경총차단의 수술 중 혈역학적 변화 및 술 후 제통 효과

Abstract

Abstract The intraoperative hemodynamic changes and postoperative analgesic effect for interscalene brachial plexus block for arthroscopic shoulder surgery

Kim Dong Joon M.D. Advisor : Prof. So Keum Young M.D. Ph.D. Department of Medicine, Graduate School of Chosun University

Background and Objectives: Arthroscopic shoulder surgery was more noninvasive and painless than open, it often caused the intraoperative hemodynamic instability and severe postoperative pain. Interscalene brachial plexus block (IBPB) is a well recognized and efficient technique for controlling pain after major open shoulder surgery. The aim of this study investigated the efficacy of interscalene brachial plexus block of intraoperative hemodynamic changes and postoperative pain undergoing arthroscopic shoulder surgery.

Materials and Methods: Forty patients undergoing elective arthroscopic shoulder surgery for rotator cuff repair were randomly allocated to two groups. Group 1: (IBPB with saline, n = 20) and Group 2: (IBPB with ropivacaine, n=20). IBPB was done with 0.5% ropivacaine 10ml guided by nerve stimulator before anesthesia induction. The hemodynamics were recorded before incision and 1, 3, 5, 10, 20 minutes after insicion. The visual analog scale pain scores were recorded 1, 2, 6, 12, 24 hours after operation.

Results: The hemodynamics were significantly more stable in group 2 than 1 (P < 0.05). Compared with the Group 1, the Group 2 significantly reduced the postoperative pain scores during 12 hours (p < 0.01).

Conclusion: IBPB was effective for controlling the hemodynamic changes during shoulder arthroscopic surgery and reduced the postoperative pain.

Keywords: Arthroscopic, Hemodynamics, Interscalene block, Postoperative analgesia