Clinical Application And The Effect Investigation Of Continuous Interscalene Brachial Plexus Block

Objective: Comparision of the efficacy between neurostimulation-guidedcontinuous and single interscalene brachial plexus block, provide the reasonablebasis for clinical application continuous interscalene brachial plexus block.Method:40patients undergoing unilateral upper limb surgery in tnesecond department of first hospital of jilin university in March2012toDecember2012, aged20-60years, weighed45-80kg, ASAⅠ～Ⅱ, duration ofsurgery≥6h, were selected, including14cases of female patients,26cases ofmale. The patients were randomly divide into2group (n=20each), thecontinuous interscalene brachial plexus block (A group) and the singleinterscalene brachial plexus block (B group). After arrival in operating room,every patient was given intravenous in arms, and was carried out monitoringof three lead electrocardiogram (ECG), blood oxygen saturation (SpO2),noninvasive blood pressure (NIBP). The patients of each group were positionedsupine, with the head turned to the opposite side and a small thin pillow placedunder the surgical side shoulder. The interscalene groove was identified by usingsurface landmarks and the positioning mode (10mA，1ms，2Hz) of a preparednerve stimulator. An needle was connected to the nerve stimulator, initially setup to piercing mode (1mA，1ms，2Hz). Until the needle elicited motor responses,the current was decreased to0.3-0.4mA, with a maintain motor response.Then20ml ropivacaine was injected. A catheter was placed in the interscalenegroove through the needle in only A group. For postoperative analgesia,patient-controlled regional analgesia (PCRA) was provided in group A, andpatient-controlled intravenous analgesia (PCIA) was provided in group B. Theanesthesia time, cases and method of additional drugs, VAS scores and whether the surgeons was satisfied was recorded. Statistical processing is completed withSPSS17.0, P<0.05is considered as statistical significance.Result:1.General information had no statistical significance (P>0.05).2.Intraoperative data shows:1).The cases of additional drugs in two groups had nostatistical significance (P>0.05), but group A showed apparent simplicity in thesurgical management. The negative effect had statistical significance (P<0.05).2).The satisfaction of surgeon between two group had statistical significance(P<0.05).3.Compared with group B, VAS scores of group A in postoperative12h and24h had statistical significance (P<0.05).Conclusion:1. Compared with single interscalene brachial plexus block,continuous interscalene brachial plexus block has the obvious superiority in theupper limb surgery for a long time.2. The effect of PCRA is more exact forpostoperative analgesia.