探讨艾司氯胺酮在超声引导下选择性颈神经根阻滞中对肩关节镜术后康复的价值研究

To Investigate the Value of Esketamine in the Postoperative Rehabilitation of Shoulder Arthroscopy in Ultrasound-guided Selective Cervical Nerve Root Block

目的探究艾司氯胺酮在超声引导下选择性颈神经根阻滞中对肩关节镜术后康复的价值。方法选取行肩关节镜手术患者80例作为研究对象,按照随机数表法分为对照组(n=40)和观察组(n=40),两组均经超声引导行颈神经根选择性阻滞,对照组阻滞前给予生理盐水静脉输注,观察组阻滞前给予艾司氯胺酮静脉输注,观察两组术后3、6、12、24h时的视觉模拟疼痛(VAS)评分和运动神经阻滞(MBS)评分,手术前、手术5min、手术15min及拔管后30min时的血液动力学变化情况。结果观察组术后6h和术后12h时VAS评分明显低于对照组差异有统计学意义(P<0.05),观察组术后3h和6h时MBS评分明显高于对照组同时点差异有统计学意义(P<0.05),观察组患者手术5min、手术15min及拔管30min时MAP与HR水平均明显低于对照组差异有统计学意义(P<0.05)。结论艾司氯胺酮在超声引导下选择性颈神经根阻滞效果确切,可有效维持术中血流动力学稳定,术后镇痛效果良好,可迅速恢复前臂运动功能。

Objective To explore the value of esmketamine in ultrasound-guided selective cervical nerve root block for rehabilitation after shoulder arthroscopy.Methods 80 patients who underwent shoulder arthroscopic surgery were selected as the research objects.They were randomly divided into control group(n=40)and observation group(n=40).Both groups underwent selective cervical nerve root block under ultrasound guidance.The control group was given normal saline intravenous infusion before block,and the observation group was given esmketamine intravenous infusion before block.3h,6h,12h Visual analogue pain(VAS)score and motor nerve block(MBS)score at 24 hours,and hemodynamic changes before operation,5 minutes after operation,15 minutes after operation and 30 minutes after extubation.Results The VAS score of the observation group was significantly lower than that of the control group at 6h and 12h after operation(P<0.05),the MBS score of the observation group was significantly higher than that of the control group at 3H and 6h after operation(P<0.05),and the map and HR levels of the observation group were significantly lower than those of the control group at 5 min,15 min and 30 min after extubation(P<0.05).Conclusion The effect of selective cervical nerve root block with esmketamine under ultrasound guidance is accurate,which can effectively maintain the stability of intraoperative hemodynamics,have good postoperative analgesic effect,and quickly restore the motor function of forearm.