当前位置： SCI文献检索 > REGIONAL ANESTHESIA AND PAIN MEDICINE期刊下所有文献 > Triple-blind randomized clinical trial of time until sensory change using 1.5% mepivacaine with epinephrine, 0.5% bupivacaine, or an equal mixture of both for infraclavicular block.

Triple-blind randomized clinical trial of time until sensory change using 1.5% mepivacaine with epinephrine, 0.5% bupivacaine, or an equal mixture of both for infraclavicular block.

Abstract：

BACKGROUND AND OBJECTIVES:Practitioners mix faster-onset, intermediate-duration local anesthetics (LAs) with slower-onset, long-duration LAs to get fast peripheral nerve block (PNB) onset and long duration. We hypothesized that 1.5% mepivacaine (with epinephrine) (mepivacaine) or 1.5% mepivacaine (with epinephrine) mixed with 0.5% bupivacaine (mixed) would reduce PNB sensory onset by 20% or more versus 0.5% bupivacaine alone (bupivacaine). METHODS:Patients (n = 93) having arm surgery were randomized to 1 of the 3 LA groups. Infraclavicular PNB was administered using 1 of 3 LAs; afterward, PNB sensory (motor) onset, duration, and other outcomes were assessed. Subjects, physicians, and the biostatistician were blinded until study completion. RESULTS:Median (interquartile range) PNB sensory onset (in minutes) was as follows: mepivacaine, 3 (3-6); mixed, 6 (3-6); and bupivacaine, 6 (3-12) (P = 0.0085). Mepivacaine PNB sensory onset was not faster than mixed (P = 0.57), but mixed was faster than bupivacaine (P = 0.0035). More mixed group patients achieved PNB sensory onset (0.81) versus the bupivacaine group (0.54) at 6 mins. Median (interquartile range) PNB motor onset (in minutes) was as follows: mepivacaine, 15 (12-18); mixed, 17 (12-21); and bupivacaine, 21 (12-24) (P < 0.0001). Median sensory and motor PNB duration (in minutes) was as follows: mepivacaine, 281 and 320; mixed, 439 and 556; and bupivacaine, 850 and 1109. Sensory (motor) PNB duration was shorter with mepivacaine versus mixed (P < 0.0001, P = 0.034), and mixed was shorter versus bupivacaine (P = 0.0243, P = 0.034). CONCLUSIONS:Mixing 1.5% mepivacaine (with epinephrine) with 0.5% bupivacaine speeds up PNB sensory (motor) onset compared with 0.5% bupivacaine alone.

journal_name

Reg Anesth Pain Med

journal_title

Regional anesthesia and pain medicine

authors

Laur JJ,Bayman EO,Foldes PJ,Rosenquist RW

doi

10.1097/AAP.0b013e318236bc30

subject

Has Abstract

pub_date

2012-01-01 00:00:00

pages

28-33

issue

eissn

1098-7339

issn

1532-8651

journal_volume

pub_type

杂志文章,随机对照试验

在线工具

Triple-blind randomized clinical trial of time until sensory change using 1.5% mepivacaine with epinephrine, 0.5% bupivacaine, or an equal mixture of both for infraclavicular block.