肩关节镜术后肩峰下间隙镇痛的临床研究（英文）

The clinical research of subacromial analgesia after arthroscopic shoulder surgery

[目的]观察肩峰下间隙自控镇痛用于肩关节镜术后镇痛效果和不良反应。[方法]选择关节镜下肩峰成形术患者60例,采用随机数字表法随机分为两组,肩峰下间隙自控镇痛组(SA-PCA)和静脉自控镇痛组(IV-PCA)。SA-PCA组为0.2%的罗哌卡因持续泵注背景剂量为5 ml/h,负荷量为8 ml,单次剂量为5 ml,按压锁定时间20 min;IA-PCA组为2μg/ml的舒芬太尼持续泵注背景剂量为2 ml/h,负荷量为2 ml,单次剂量为2 ml,按压锁定时间20 min。观察术后2、6、12、24、48 h的静态、动态VAS评分、不良反应以及镇痛泵的使用情况,患者对镇痛总体满意度。[结果]SA-PCA组在静息状态下的VAS评分与IV-PCA无明显差别,SA-PCA组在活动状态下的VAS评分明显低于IV-PCA组(P<0.05),SA-PCA组的不良反应发生率低于IV-PCA组(P<0.05),SA-PCA组患者的总体满意度高于IV-PCA组患者的总体满意度(P<0.05)。[结论]肩峰下间隙自控镇痛用于肩关节镜术后可起到良好的镇痛效果且不良反应发生率较低。

[ Objectlve]To investigate the postoperative analgesic effect and side effects of subacromial patient -controlled analgesia （ SA - PCA） after arthroscopic shoulder surgery. [ Method ] Sixty patients were randomized into one of the two types of analgesia operative ,the SA - PCA group and the IV - PCA group. In the SA - PCA group,patients received 0.2% ropivacaine at a rate of 5 ml/h with a load bolus dose of 8ml, and single bolus does of 5 ml, at a 20 - minute lockout period via a PCA pump. In the IV -PCA group, patients received 2pLg/ml sufentanil at a rate of 2ml/h with load bolus dose of 2 ml, single bolus does of 2 ml,at a 20 - minute lockout period via a PCA pump. Pain was regularly assessed at 2 h,6 h,12 h, 24 h,48 h by visual analog scale （VAS） ,the side effects,the usage of PCA and the satisfaction were recorded. [ Result]The postoperative VAS at rest state postoperative had no significant difference between the SA - PCA group and the IV - PCA group. The postoperative VAS at mo- tion state postoperative was lower in the SA - PCA group than in the IV - PCA group （ P 〈 0.05 ）. The incidence of the side effects was lower in the SA - PCA group than in the IV - PCA group （ P 〈 0.05 ）. Patient satisfaction was higher in the SA - PCA than in the IV - PCA. [ Conclusion ] The subacromial patient - controlled analgesia had better analgesia effect and lower incidence of side effects after arthroscopic shoulder surgery.