针刺麻醉与镇痛泵在肩关节术后镇痛领域中的应用及评价

Application and evaluation of acupuncture anesthesia and analgesia pump in post-operative analgesia of shoulder surgery

以行肩关节手术的患者作为研究对象,比较和评价了针刺麻醉与肩峰下自控型镇痛泵对术后镇痛的疗效与安全性,指标包括疼痛视觉模拟评分(VAS)、肩关节活动度(ROM)、Lovett肌力分级等,结果显示镇痛泵组的胃肠道不良反应发生率(7/64)、基础病复发率(4/64),及总体不良反应发生率(16/64)均显著高于针刺组(0/70)(0/70)(4/70),在轻度疼痛者中,2组的VAS未见差异,但针刺组的ROM更大,在中、重度疼痛者中,镇痛泵组的VAS低于针刺组,但2组的ROM及肩关节肌力未见差异,说明针刺麻醉的安全性极佳,可促进术后康复,适用于轻度疼痛者及合并相关内科基础病的中、重度疼痛者。

Post-operative pain management for shoulder surgery is closely related to the complications and early functional rehabilitation.The purpose of this study is to compare and evaluate the efficacy and safety of acupuncture anesthesia and subacromial self-controlled anesthesia pump in the postoperative analgesia for patients undergoing shoulder surgery.The indicators included the pain visual analog score(VAS),shoulder range of motion(ROM),Lovett muscle strength grade,etc.The results showed that the incidence of gastrointestinal adverse reactions(7/64),recurrence rate of basic diseases(4/64),and overall adverse reaction rate(16/64)in the analgesia pump group were higher than those of the acupuncture group(0/70)(0/70)(4/70).In mild pain patients,there was no difference in VAS between the two groups but the ROM of the acupuncture group was larger.In moderate and severe patients,VAS of the analgesia pump group was lower,but no difference in ROM and shoulder muscle strength between the two groups.It suggests that acupuncture anesthesia has superior safety and is good for rehabilitation,which is especially suitable for mild pain patients as well as the moderate to severe pain patients who are complicated with related basic medical diseases.