超声引导下臂丛上干和颈浅丛神经阻滞联合全身麻醉应用于肩关节镜手术的效果

The Effect of Ultrasound-guided Upper Trunk of Lower Brachial Plexus and Superficial Cervical Plexus Nerve Block Combined with General Anesthesia in Shoulder Arthroscopic Surgery

目的探讨超声引导下臂丛上干和颈浅丛神经阻滞联合全身麻醉应用于肩关节镜手术中的效果。方法选取2018年3月—2020年10月期间该院收治的322例肩关节镜手术患者,通过随机数字表法分成两组,包括对照组(n=161)和观察组(n=161),对照组患者采用全身麻醉,观察组患者采用超声引导下臂丛上干和颈浅丛神经阻滞联合全身麻醉,比较两组手术时间、拔管时间、镇痛麻醉药物使用量,不同时间点两组患者心率和平均动脉压(MAP)变化情况。结果与对照组相比,观察组患者手术时间(55.62±3.48)min、拔管时间(4.25±1.36)min更短,舒芬太尼、七氟烷等药物使用量(22.37±3.25)μg、(15.27±2.15)mL更少,差异有统计学意义(t=11.500、31.311、38.219、34.288,P<0.05);T1~T4观察组患者心率分别为(56.25±3.31)、(55.47±3.25)、(54.85±2.94)、(66.86±3.29)次/min和MAP分别为(68.14±2.85)、(67.83±3.26)、(72.35±2.74)、(93.46±3.23)mmHg,均低于对照组,差异有统计学意义(t=19.289、29.491、31.738、22.626、51.706、36.237、45.709、41.899,P<0.05)。结论超声引导下臂丛上干和颈浅丛神经阻滞联合全身麻醉应用于肩关节镜手术中麻醉效果良好,可保证手术顺利性,因此可在临床中推广。

Objective To investigate the effect of ultrasound-guided upper trunk of lower brachial plexus and superficial cervical plexus nerve block combined with general anesthesia in shoulder arthroscopic surgery.Methods Selected 322 patients undergoing arthroscopic shoulder surgery in the hospital from March 2018 to October 2020,and divided them into two groups by random number table method,including the control group(n=161)and the observation group(n=161)Patients in the control group were given general anesthesia,and the patients in the observation group were given ultrasound-guided lower brachial plexus and superficial cervical plexus block combined with general anesthesia.The operation time,extubation time,and the amount of anesthetic drugs used in the two groups,changes in heart rate and mean arterial pressure(MAP)of the two groups of patients at different time points were compared.Results Compared with the control group,the observation group had shorter operation time(55.62±3.48)min and extubation time(4.25±1.36)min.Sufentanil,sevoflurane and other drugs used(22.37±3.25)μg、(15.27±2.15)mL less,the difference was statistically significant(t=11.500,31.311,38.219,34.288,P<0.05);the heart rate of patients in the T1-T4 observation group(56.25±3.31)times/min,(55.47±3.25)times/min,(54.85±2.94)times/min,(66.86±3.29)times/min and MAP(68.14±2.85)mmHg,(67.83±3.26)mmHg,(72.35±2.74)mmHg,(93.46±3.23)mmHg was lower than the control group,the difference was statistically significant(t=19.289,29.491,31.738,22.626,51.706,36.237,45.709,41.899,P<0.05).Conclusion Ultrasound-guided upper trunk of the lower brachial plexus and superficial cervical plexus nerve block combined with general anesthesia in shoulder arthroscopic surgery have a good anesthesia effect,which can ensure the smoothness of the operation,so it can be promoted in clinical practice.