PDF(Pubmed)
Abstract：
UNASSIGNED: Interscalene nerve catheters have been proven to be effective in managing pain after rotator cuff repair (RCR) surgery. Liposomal bupivacaine is a newer approved therapy for use around the interscalene brachial plexus, but its analgesic efficacy has limited supporting data in various patient populations.
UNASSIGNED: The purpose of this study was to investigate the quality of recovery after arthroscopic RCR in patients who received either single-injection interscalene liposomal bupivacaine or an interscalene peripheral nerve catheter. It was hypothesized that interscalene peripheral nerve catheters would provide more reliable analgesia and improved patient satisfaction 48 hours after surgery.
UNASSIGNED: Cohort study; Level of evidence, 2.
UNASSIGNED: Enrolled were 93 consecutive patients who underwent arthroscopic rotator cuff surgery at a single ambulatory surgery center between October 2020 and June 2021. Of these patients, 13 were lost to follow-up; thus, 80 patients were included in statistical analysis. One group of patients (n = 48) received a preoperative interscalene nerve block placed with 10 mL 0.5% bupivacaine and 10 mL 1.3% liposomal bupivacaine. The second group (n = 32) received a preoperative interscalene catheter with an initial bolus of 20 mL 0.25% bupivacaine and a 0.2% ropivacaine infusion by an elastomeric pump set at 10 mL/hr for 48 hours. The primary outcome was the difference between preoperative and 48-hour postoperative quality of recovery-15 (QoR-15) scores. Secondary outcomes included visual analog pain scores, opioid use, and patient satisfaction. Complications and adverse effects were also noted. The Kruskal-Wallis test was used to analyze means and standard deviations for continuous endpoints; Fisher exact test was used to analyze counts and proportions for categorical endpoints.
UNASSIGNED: The liposomal bupivacaine group had a mean reduction of 3.9 in their postoperative QoR-15 scores, and the catheter group had a mean reduction of 25.1 in their postoperative QoR-15 scores, indicating a significantly worse functional recovery period compared with liposomal bupivacaine within the first 48 hours (P < .001). Patients who received liposomal bupivacaine also had significantly lower pain scores on the second postoperative day, improved quality of sleep, and improved satisfaction with analgesia (P < .05 for all).
UNASSIGNED: The use of interscalene liposomal bupivacaine demonstrated significantly improved quality of recovery when compared with interscalene nerve catheter after RCR.
UNASSIGNED: The purpose of this study was to investigate the quality of recovery after arthroscopic RCR in patients who received either single-injection interscalene liposomal bupivacaine or an interscalene peripheral nerve catheter. It was hypothesized that interscalene peripheral nerve catheters would provide more reliable analgesia and improved patient satisfaction 48 hours after surgery.
UNASSIGNED: Cohort study; Level of evidence, 2.
UNASSIGNED: Enrolled were 93 consecutive patients who underwent arthroscopic rotator cuff surgery at a single ambulatory surgery center between October 2020 and June 2021. Of these patients, 13 were lost to follow-up; thus, 80 patients were included in statistical analysis. One group of patients (n = 48) received a preoperative interscalene nerve block placed with 10 mL 0.5% bupivacaine and 10 mL 1.3% liposomal bupivacaine. The second group (n = 32) received a preoperative interscalene catheter with an initial bolus of 20 mL 0.25% bupivacaine and a 0.2% ropivacaine infusion by an elastomeric pump set at 10 mL/hr for 48 hours. The primary outcome was the difference between preoperative and 48-hour postoperative quality of recovery-15 (QoR-15) scores. Secondary outcomes included visual analog pain scores, opioid use, and patient satisfaction. Complications and adverse effects were also noted. The Kruskal-Wallis test was used to analyze means and standard deviations for continuous endpoints; Fisher exact test was used to analyze counts and proportions for categorical endpoints.
UNASSIGNED: The liposomal bupivacaine group had a mean reduction of 3.9 in their postoperative QoR-15 scores, and the catheter group had a mean reduction of 25.1 in their postoperative QoR-15 scores, indicating a significantly worse functional recovery period compared with liposomal bupivacaine within the first 48 hours (P < .001). Patients who received liposomal bupivacaine also had significantly lower pain scores on the second postoperative day, improved quality of sleep, and improved satisfaction with analgesia (P < .05 for all).
UNASSIGNED: The use of interscalene liposomal bupivacaine demonstrated significantly improved quality of recovery when compared with interscalene nerve catheter after RCR.
摘要：
未经证实：肌间沟神经导管已被证明可有效控制肩袖修复（RCR）手术后的疼痛。脂质体布比卡因是一种较新的批准的治疗方法，可在肌间沟臂丛神经周围使用，但其镇痛效果在不同患者人群中的支持数据有限。
UNASSIGNED：本研究的目的是调查接受单次注射肌间烯脂质体布比卡因或肌间烯外周神经导管的患者关节镜RCR后的恢复质量。据推测，肌间沟周围神经导管将在手术后48小时提供更可靠的镇痛效果并提高患者满意度。
未经批准：队列研究；证据水平，2.
UNASSIGNED：在2020年10月至2021年6月期间，共有93名连续患者在一个门诊手术中心接受了关节镜肩袖手术。在这些病人中,13人失去了后续行动；因此，对80例患者进行统计分析。一组患者（n=48）接受了10mL0.5％布比卡因和10mL1.3％布比卡因脂质体的肌间沟神经阻滞。第二组（n=32）接受术前肌间沟导管，初始推注20mL0.25％布比卡因，并通过设置为10mL/hr的弹性泵输注0.2％罗哌卡因，持续48小时。主要结果是术前和术后48小时恢复质量-15（QoR-15）评分之间的差异。次要结果包括视觉模拟疼痛评分，阿片类药物的使用，患者满意度。还注意到并发症和不良反应。使用Kruskal-Wallis检验分析连续终点的均值和标准偏差;使用Fisher精确检验分析分类终点的计数和比例。
UNASSIGNED：布比卡因脂质体组术后QoR-15评分平均降低3.9，导管组术后QoR-15评分平均降低25.1,表明与布比卡因脂质体相比，在最初48小时内功能恢复明显更差（P<.001）。接受布比卡因脂质体的患者在术后第二天的疼痛评分也明显降低，改善睡眠质量，并提高镇痛满意度（P<0.05）。
UNASSIGNED：与RCR后的肌间沟神经导管相比，使用肌间沟脂质体布比卡因的恢复质量显着提高。
UNASSIGNED：本研究的目的是调查接受单次注射肌间烯脂质体布比卡因或肌间烯外周神经导管的患者关节镜RCR后的恢复质量。据推测，肌间沟周围神经导管将在手术后48小时提供更可靠的镇痛效果并提高患者满意度。
未经批准：队列研究；证据水平，2.
UNASSIGNED：在2020年10月至2021年6月期间，共有93名连续患者在一个门诊手术中心接受了关节镜肩袖手术。在这些病人中,13人失去了后续行动；因此，对80例患者进行统计分析。一组患者（n=48）接受了10mL0.5％布比卡因和10mL1.3％布比卡因脂质体的肌间沟神经阻滞。第二组（n=32）接受术前肌间沟导管，初始推注20mL0.25％布比卡因，并通过设置为10mL/hr的弹性泵输注0.2％罗哌卡因，持续48小时。主要结果是术前和术后48小时恢复质量-15（QoR-15）评分之间的差异。次要结果包括视觉模拟疼痛评分，阿片类药物的使用，患者满意度。还注意到并发症和不良反应。使用Kruskal-Wallis检验分析连续终点的均值和标准偏差;使用Fisher精确检验分析分类终点的计数和比例。
UNASSIGNED：布比卡因脂质体组术后QoR-15评分平均降低3.9，导管组术后QoR-15评分平均降低25.1,表明与布比卡因脂质体相比，在最初48小时内功能恢复明显更差（P<.001）。接受布比卡因脂质体的患者在术后第二天的疼痛评分也明显降低，改善睡眠质量，并提高镇痛满意度（P<0.05）。
UNASSIGNED：与RCR后的肌间沟神经导管相比，使用肌间沟脂质体布比卡因的恢复质量显着提高。
