选择性颈神经根阻滞与臂丛神经阻滞在肩关节镜术后镇痛中的效果对比

Comparison Effect of Selective Cervical Nerve Root Block and Brachial Plexus Block in Analgesia after Shoulder Arthroscopy

目的:探讨选择性颈神经根阻滞与臂丛神经阻滞在肩关节镜术后镇痛中的临床价值。方法:将本院收治的110例择期行肩关节镜手术患者以随机数字表法分为对照组和研究组,每组55例。对照组行传统臂丛神经阻滞,研究组行选择性颈神经根阻滞。对两组麻醉阻滞效果、术后不同时间点疼痛程度评分、上肢运动评分(前后钟摆、划圆圈、外展),术后麻醉安全性及患者满意度进行比较。结果:研究组神经起效时间明显短于对照组(P<0.05);研究组术后4、12 h、24 h VAS评分均低于对照组(P<0.05);研究组术后4、12 h前后钟摆、划圆圈、外展评分均较对照组显著升高(P<0.05);研究组不良反应发生率低于对照组,患者总满意度高于对照组(P<0.05)。结论:选择性颈神经根阻滞用于肩关节镜术后镇痛比臂丛神经阻滞更安全、有效,能显著改善患肢术后疼痛,有利于患者术后早期功能锻炼,促进肩关节功能康复,且不良反应较少,患者满意度较高,可作为手术患者首选的镇痛方案。

Objective:To investigate the effect of selective cervical nerve root block and brachial plexus block in analgesia after shoulder arthroscopy.Method:A total of 110 patients undergoing selective shoulder arthroscopic surgery in our hospital were divided into the control group and the study group according to random number table method,55 cases in each group.The control group was given traditional brachial plexus block,and the study group was given selective cervical nerve root block.Then the anesthesia block effect,pain score at different time points after operation,upper extremity motor score(front and rear pendulus,circle,abduction),postoperative anesthesia safety and patient satisfaction of two groups were compared.Result:The neurological onset time of the study group was lower than that of the control group(P<0.05).The VAS scores of the study group at 4,12,24 h after operation were shorter than those of the control group(P<0.05).The scores of front and rear pendulus,circle,abduction of the study group at 4,12 h after operation were higher than those of the control group(P<0.05).The incidence of adverse reactions in the study group was significantly lower than that of the control group,and the total patients’ satisfaction was better than that of the control group(P<0.05).Conclusion:Selective cervical nerve root block is safer and more effective than brachial plexus block in analgesia after shoulder arthroscopy,can significantly improve the pain of affected limbs after operation,facilitate early functional exercise after operation,promote shoulder joint function recovery,with fewer side effects,and improve patient satisfaction.It can be used as the first choice of analgesia for patients undergoing surgery.