超声引导下臂丛联合胸椎旁阻滞对肩胛骨骨折内固定患者术后镇痛效果的影响

Effect of ultrasound-guided brachial plexus combined with thoracic paravertebral block on the effect of postoperative analgesia in the patients with scapular fractures receiving internal fixation

目的探讨超声引导下臂丛联合胸椎旁阻滞在肩胛骨骨折内固定患者中的镇痛作用。方法选取2017年2月～2018年2月收治的50例行肩胛骨骨折内固定的患者。对照组为常规全麻,观察组为超声引导下臂丛联合胸椎旁阻滞全麻。结果观察组术中出血量为(184.31±20.67)mL,对照组术中出血量为(192.67±23.54)mL。两组术中指标对比差异显著(P<0.05)。观察组在PACU停留时间为(60.52±5.14)min,对照组在PACU停留时间为(69.47±5.28)min。两组术后镇痛效果对比差异显著(P<0.05)。观察组术后VAS评分为(2.53±0.53)分,对照组术后VAS评分为(5.78±0.48)分。两组在术后VAS评分对比差异显著(P<0.05)。结论在肩胛骨骨折内固定手术中,实施超声引导下臂丛联合胸椎旁阻滞,可以充分改善患者的手术相关指标,缓解患者麻醉后和术后的疼痛,对于促进患者身体康复具有重要的影响,可以在临床中广泛应用,价值显著。

Objective To investigate the analgesic effect of ultrasound-guided brachial plexus combined with thoracic paravertebral block in the patients with scapular fractures receiving internal fixation. Methods 50 patients undergoing scapular fracture internal fixation from February 2017 to February 2018 were selected for clinical study. The control group was given conventional general anesthesia. The observation group was given general anesthesia with ultrasound-guided brachial plexus combined with thoracic paravertebral block. Results The intraoperative blood loss in the observation group was（184.31±20.67） mL, and the intraoperative blood loss in the control group was（192.67±23.54） mL. There were significant differences in intraoperative indicators between the two groups（P〈0.05）. The PACU retention time in the observation group was（60.52±5.14） min. The PACU retention time in the control group was（69.47±5.28） min. There was significant difference in postoperative analgesic effect between the two groups（P〈0.05）. The VAS score in the observation group was（2.53±0.53） points after surgery. The VAS score in the control group was（5.78±0.48） points after surgery. There was significant difference in VAS scores between the two groups after surgery（P〈0.05）. Conclusion Ultrasound-guided brachial plexus combined with thoracic paravertebral block in the internal fixation of scapular fractures can substantially improve the patient＇s surgically-relevant parameters and relieve post-anesthetic and post-operative pain. It has an important effect on promoting the physical rehabilitation of patients and can be widely used in clinical practice with significant value.