超声引导下星状神经节阻滞对肩关节镜下肩峰成形术后镇痛和康复的影响

Effects of ultrasound-guided stellate ganglion block on postoperative analgesia and rehabilitation after arthroscopic acromioplasty

目的:探讨超声引导下星状神经节阻滞对肩关节镜下肩峰成形术后镇痛和康复的影响。方法:选取2019年7月—2021年8月行肩关节镜下肩峰成形术患者50例,随机分为观察组和对照组,每组25例。对照组给予全身麻醉,观察组行超声引导下星状神经节阻滞术再行麻醉诱导。比较两组患者术后不同时间点镇痛效果、肩关节康复效果以及不良反应发生情况。结果:不同时间点两组平均动脉压(MAP)和心率(HR)比较,差异均无统计学意义(P>0.05);术后12 h, 18 h以及24 h,观察组疼痛视觉模拟评分(VAS)低于对照组,差异有统计学意义(P<0.05);术后6个月,观察组疼痛、功能、关节前屈角度、前屈肌力以及患者满意度均高于对照组,差异均有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:超声引导下星状神经节阻滞应用于肩关节镜下肩峰成形术患者,术后镇痛效果明显,可促进患者术后肩关节功能康复,且安全性较高。

Objective:To investigate the effect of ultrasound-guided stellate ganglion block on postoperative analgesia and rehabilitation after arthroscopic acromioplasty.Methods:Fifty patients who underwent arthroscopic acromioplasty in hospital from July 2019 to August 2021 were selected as the research objects,and were randomly divided into observation group and control group,with 25 patients in each group.Patients in the control group were given general anesthesia,and patients in the observation group were given ultrasound-guided stellate ganglion block for anesthesia induction.Analgesia effect,rehabilitation effect of shoulder joint and occurrence of adverse reactions were compared between the two groups at different time points after surgery.Results:There were no significant differences in mean arterial pressure(MAP)and heart rate(HR)between the two groups at different time periods(P>0.05).The visual analogue scale/score(VAS)of the observation group was lower than that of the control group at 12 h,18 h and 24 h after surgery,and the difference was statistically significant(P<0.05).Six months after surgery,the pain,function,joint flexion angle,flexion muscle strength and patient satisfaction in the observation group were higher than those in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Ultrasound-guided stellate ganglion block has obvious postoperative analgesia effect in patients undergoing arthroscopic acromioplasty,and can promote postoperative shoulder function rehabilitation,with high safety.