Sina Yousef, Mathias Therkel Steensbæk, Aurelien-Xuan Rosendal Bahuet, Rasmus Linnebjerg Knudsen, Cecilie Dupont Harwood, Charlotte Vallentin Rosenstock, Michelle Fog Andersen, Christian Rothe, Kai Henrik Wiborg Lange, Anders Kehlet Nørskov, Lars Hyldborg Lundstrøm
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Compared with that in the R150 group, the mean duration of analgesia was reduced by 311 min (95% confidence interval [CI], 212 to 411; P < 0.001) in the R100-L200 group and by 177 min (95% CI, 64 to 289; P = 0.003) in the R150-L200 group. The difference between the R100-L200 and R150-L200 groups was not statistically significant after adjustment for multiple testing (135 min; 95% CI, 13 to 257; P = 0.031). Sensory onset times ranged insignificantly from 17 to 18 min across groups.</p><p><strong>Conclusion: </strong>Mixing lidocaine-epinephrine with ropivacaine significantly shortened the duration of analgesia by up to 5 h without affecting the sensory onset time. 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引用次数: 0
摘要
背景：短效和长效局部麻醉药的联合使用传统上与阻滞持续时间缩短有关，尽管证据仍不一致。目的：探讨固定或减少剂量的长效局部麻醉剂（罗哌卡因）与短效药物（利多卡因-肾上腺素）混合对锁骨下外侧阻滞的镇痛持续时间和感觉起效时间的影响。设计：随机、盲法、主动对照的优势试验。环境：丹麦首都地区的一家三级医院，2024年4月18日至11月23日。患者：78例在锁骨下侧臂丛神经阻滞下行手外科手术的患者。干预：患者分为三组：R150: 30 ml罗哌卡因5 mg ml -1， R100-L200: 20 ml罗哌卡因5 mg ml -1 + 10 ml利多卡因-肾上腺素20 mg ml -1 + 5 μg ml -1， R150- l200: 20 ml罗哌卡因7.5 mg ml -1 + 10 ml利多卡因-肾上腺素20 mg ml -1 + 5 μg ml -1。主要观察指标：主要观察指标为镇痛持续时间，次要观察指标为感觉发病时间。结果：R150组镇痛时间为847 (152)min， R100-L200组为536 (198)min， R150- l200组为671 (234)min。与R150组相比，平均镇痛时间缩短311 min(95%可信区间[CI]， 212 ~ 411)； P结论：利多卡因-肾上腺素与罗哌卡因混合可显著缩短镇痛时间，最长可缩短5 h，且不影响感觉起效时间。该效应与罗哌卡因剂量无关。试验注册号：ClinicalTrials.gov标识符：NCT06381622。
The effect of combining lidocaine and ropivacaine on the duration and onset time of an ultrasound-guided infraclavicular brachial plexus nerve block: A randomised controlled trial.
Background: The combination of short- and long-acting local anaesthetics is traditionally associated with reduced block duration, though evidence remains inconsistent.
Objectives: To investigate the effects of a fixed or reduced dose of a long-acting local anaesthetic (ropivacaine) mixed with a short-acting agent (lidocaine-epinephrine) on duration of analgesia and sensory onset time in lateral infraclavicular blocks.
Setting: A tertiary hospital in the Capital Region of Denmark, from 18 April to 23 November 2024.
Patients: Seventy-eight patients undergoing hand surgery under lateral infraclavicular brachial plexus nerve block.
Intervention: Patients were allocated to three groups: R150: 30 ml ropivacaine 5 mg ml -1 , R100-L200: 20 ml ropivacaine 5 mg ml -1 + 10 ml lidocaine-epinephrine 20 mg ml -1 + 5 μg ml -1 and R150-L200: 20 ml ropivacaine 7.5 mg ml -1 + 10 ml lidocaine-epinephrine 20 mg ml -1 + 5 μg ml -1 .
Main outcome measures: The primary outcome was duration of analgesia, and secondary outcomes included sensory onset time.
Results: The duration of analgesia was 847 (152) min in the R150 group, 536 (198) min in the R100-L200 group, and 671 (234) min in the R150-L200 group. Compared with that in the R150 group, the mean duration of analgesia was reduced by 311 min (95% confidence interval [CI], 212 to 411; P < 0.001) in the R100-L200 group and by 177 min (95% CI, 64 to 289; P = 0.003) in the R150-L200 group. The difference between the R100-L200 and R150-L200 groups was not statistically significant after adjustment for multiple testing (135 min; 95% CI, 13 to 257; P = 0.031). Sensory onset times ranged insignificantly from 17 to 18 min across groups.
Conclusion: Mixing lidocaine-epinephrine with ropivacaine significantly shortened the duration of analgesia by up to 5 h without affecting the sensory onset time. This effect was independent of the ropivacaine dose.
期刊介绍：
The European Journal of Anaesthesiology (EJA) publishes original work of high scientific quality in the field of anaesthesiology, pain, emergency medicine and intensive care. Preference is given to experimental work or clinical observation in man, and to laboratory work of clinical relevance. The journal also publishes commissioned reviews by an authority, editorials, invited commentaries, special articles, pro and con debates, and short reports (correspondences, case reports, short reports of clinical studies).
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