Effects of programmed intermittent thoracic paravertebral bolus of levobupivacaine on the spread of sensory block: a randomized, controlled, double-blind study

• Material Type: 博士論文
• Title: Effects of programmed intermittent thoracic paravertebral bolus of levobupivacaine on the spread of sensory block: a randomized, controlled, double-blind study
• Author/Editor: 樋田, 久美子
• Author Heading: 樋田, 久美子
• Publication, Distribution, etc.: BMJ Publishing Group
• Publication Date: 2020-09-02
• Publication Date (W3CDTF): 2020-09-02
• Alternative Title: 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
• Periodical title: Regional Anesthesia & Pain Medicine
• No. or year of volume/issue: 44 3
• Volume: 44
• Issue: 3
• Pages: 326-332
• ISSN (Periodical Title): ISSN : 1098-7339; ISSN : 1532-8651
• Degree grantor/type: Nagasaki University (長崎大学)
• Date Granted: 2020-09-02
• Dissertation Number: 乙医歯薬第58号
• Degree Type: 博士(医学)
• Text Language Code: eng
• Subject Heading: continuous infusion; levobupivacaine; programmed intermittent bolus; sensory block; thoracic paravertebral block
• Target Audience: 一般
• Note (General): 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 Medicine, 44(3), pp.326-332; 2019; identifier:Nagasaki University (長崎大学), 博士(医学) (2020-09-02)
• Source: https://nagasaki-u.repo.nii.ac.jp/?action=repository_action_common_download&item_id=68&item_no=1&attribute_id=70&file_no=1 （fulltext）; https://nagasaki-u.repo.nii.ac.jp/?action=repository_action_common_download&item_id=68&item_no=1&attribute_id=70&file_no=1
• Access Restrictions: インターネット公開
• Rights (production): c American Society of Regional Anesthesia & Pain Medicine 2019. No commercial re-use. See rights and permissions. Published by BMJ.This article has been accepted for publication in Regional Anesthesia & Pain Medicine, 2019 following peer review, and the Version of Record can be accessed online at http://dx.doi.org/10.1136/rapm-2018-100021.
• Related Material: http://hdl.handle.net/10069/40357
• Data Provider (Database): 国立情報学研究所 : 学術機関リポジトリデータベース（IRDB）（機関リポジトリ）; https://irdb.nii.ac.jp
• Original Data Provider (Database): 長崎大学 : 長崎大学学術研究成果リポジトリ