超声引导下锁骨上臂丛神经阻滞对肩袖修复术后镇痛效果的影响

Influence of ultrasound-guided supraclavicular block on analgesic effect after rotator cuff repair

目的探讨超声引导下锁骨上臂丛神经阻滞(SCB)对动态关节镜下肩袖修复术后镇痛效果的影响。方法将92例拟行全身麻醉动态关节镜下肩袖修复患者随机分为ISB组(采用超声引导下斜角肌间阻滞麻醉,46例)和SCB组(采用超声引导下SCB麻醉,46例)。两组术后均采用静脉自控镇痛。比较两组术后不同时间点活动和静息状态下疼痛VAS评分、阻滞效果、术后枸橼酸舒芬太尼用量、并发症发生率。结果阻滞成功率、感觉阻滞效果、运动阻滞效果、活动状态下各时间点VAS评分、并发症发生率两组比较差异均无统计学意义(P>0.05);术后枸橼酸舒芬太尼用量、静息状态下各时间点VAS评分SCB组明显少(低)于ISB组,差异均有统计学意义(P<0.05)。结论SCB用于动态关节镜下肩袖修复术后的镇痛,可减轻患者术后疼痛程度,减少术后阿片类药物使用量,可作为一种外周神经阻滞镇痛方法选择。

Objective To investigate the analgesic effect of ultrasound-guided supraclavicular block(SCB)on postoperative analgesic effect of rotator cuff repair under dynamic arthroscopy.Methods A total of 92 patients undergoing dynamic arthroscopic rotator cuff repair under general anesthesia were randomly divided into group ISB(interscaleue block anesthesia guided by ultrasound,46 cases)and group SCB(SCB block anesthesia guided by ultrasound,46 cases).Both groups were performed with potient-controlled intravenous analgesia after operation.VAS,block effect,postoperative sufentanil citrate dosage and complications were compared between the two groups at different time points of activity and resting state.Results There were no significant differences between the two groups in the success rate of block,effect of sensory block,effect of motor block,VAS at each time point of activity and incidence rate of complications(P>0.05).Postoperative dosage of sufentanil citrate,VAS at each time point in group SCB were less(lower)than in those of group ISB,the differences were statistically significant(P<0.05).Conclusions SCB can be used for analgesia in patients with rotator cuff injury repair under dynamic arthroscopy,which can reduce postoperative pain,reduce postoperative opioid use,and can be used as an alternative method for peripheral nerve block analgesia.