Abstract
INTRODUCTION
The aim of this study was to compare the postoperative analgesic effects of 2 different low volumes of local anesthetics used in interscalene nerve block with intravenous tramadol analgesia in patients underwent shoulder surgery.
METHODS
After approval of Hospital Ethics Committee (2013-4/52), 69 patients who were ASA I-III, 18-80 years old and scheduled for shoulder surgery were included in the study and randomly divided into 3 groups: Group I received 3 ml 0.5% bupivacaine, 2 ml prilocaine, total is 5 ml, Group II: 3ml 0.5% bupivacaine, 2ml prilocaine and 5ml saline total is 10ml and Group III 2 mg/kg tramadol intravenously. The interscalene nerve block was applied under general anesthesia using USG and peripheral nerve stimulator. Onset of block and recovery times, pain scores of the groups, first analgesic requirement times and total amount of analgesic consumed were compared between the groups.
RESULTS
The time for sensory and motor block onset were shorter in the high-volume group (Group II) (Sensory; 5.54 / 8.54, motor; 8.30 / 11.00 min). Sensory and motor block termination times were significantly longer in Group II (GroupI / GroupII: 399.50/288.00, 424.00/330.50 minutes). The first analgesic requirement times were significantly shorter in the intravenous tramadol group (Group I; 6.86±0.40, Grup II; 7.06±0.52, GrupIII;3.25±0.40 hour, p<0,05). Total analgesic consumption was also significantly higher in Group III. The mean pain scores were significantly lower in the block groups than the intravenous treatment group at all assessment times.
DISCUSSION AND CONCLUSION
Interscalene nerve block applied with low volume local anesthetics was found to be superior to intravenous analgesia group, similar to high volume, in terms of pain scores, additional analgesic requirement time, and total analgesic consumption. We think that adequate block success can be achieved in the interscalene nerve block performed with ultrasonography using low volume and the amount of analgesic consumption can be reduced.