自動間欠的投与法を用いた胸部傍脊椎ブロックによる感覚遮断範囲の経時的変化に関する研究：ランダム化二重盲検群間試験

• Main Author: 樋田, 久美子
• Format: Other/Unknown Material
• Language: English
• Published: BMJ Publishing Group 2020
• Subjects: continuous infusion; levobupivacaine; programmed intermittent bolus; sensory block; thoracic paravertebral block; taiga
• Online Access: https://nagasaki-u.repo.nii.ac.jp/record/68/files/ISYO58_Hida.pdf

Nagasaki University (長崎大学) 博士(医学) Background and objectives: This randomized, controlled, double-blind trial compared the effectiveness of levobupivacaine delivery of a programmed intermittent paravertebral bolus with a continuous paravertebral infusion. Methods: Thirty-two consecutively enrolled patients who underwent unilateral video-assisted thoracic surgery were randomized to receive either a programmed intermittent paravertebral bolus of 10?mL of 0.2% levobupivacaine every 2?hours (Bolus group, n=16) or a continuous paravertebral infusion of 0.2% levobupivacaine at 5?mL/hour (Infusion group, n=16) after the operation. Postoperatively, after injection of 20?mL of 0.25% levobupivacaine through the paravertebral catheter, a mechanical infusion pump was set depending on the assigned group. The primary efficacy outcome was the number of anesthetized dermatomes 24?hours after the initial bolus of levobupivacaine. The secondary efficacy outcomes included the number of anesthetized dermatomes at other time points, pain at rest and coughing, additional analgesic use and patient acceptance of the analgesic technique. Arterial levobupivacaine concentration was measured to ensure safety. P<0.05 was considered statistically significant. Results: The mean (95% CI) number of anesthetized dermatomes 24?hours after the initial bolus of levobupivacaine was significantly larger among subjects receiving programmed intermittent bolus (n=16) compared with those receiving continuous infusion (n=16; 6.8 (5.7?7.9) vs 3.1 (2.0?4.2); p<0.001). The arterial levobupivacaine concentration did not reach a toxic level. Conclusions: The programmed intermittent paravertebral bolus of levobupivacaine provided a wider dermatomal spread of sensory block than continuous paravertebral infusion with an identical hourly dose of levobupivacaine. 長崎大学学位論文 学位記番号:博(医歯薬)乙第58号 学位授与年月日:令和2年9月2日 Author: Kumiko Hida, Hiroaki Murata, Taiga Ichinomiya, Haruka Inoue, Shuntaro Sato and Tetsuya Hara Citation: Regional Anesthesia & Pain ...