超声引导下臂丛神经阻滞在肩关节镜术后镇痛的临床效果及对运动功能的影响

Clinical Effect of Ultrasound-guided Brachial Plexus Block on Analgesia after Shoulder Arthroscopy and Its Influence on Motor Function

目的分析肩关节镜术患者接受超声引导下臂丛神经阻滞麻醉对临床效果以及对运动功能的影响。方法方便选取2020年1月—2023年6月江苏大学附属武进医院收治的105例需接受肩关节镜手术的患者作为研究对象,根据抽签法分为对照组(52例,接受全身麻醉)和观察组(53例,接受超声引导下臂丛神经阻滞联合全身麻醉)。对比两组平均动脉压、心率、视觉模拟评分法(Visual Analogue Scale,VAS)评分、美国肩肘外科医师评分标准(Alliance Supplier Evaluation Standard,ASES)评分。结果观察组在T1(手术开始5 min)、T2(手术开始30 min)以及T3(拔除气管插管30 min后)时的平均动脉压、心率均低于对照组,差异有统计学意义(P均<0.05)。观察组于麻醉复苏室、术后6 h及术后12 h时的VAS评分均低于对照组,差异有统计学意义(P均<0.05)。治疗后,两组ASES评分均较治疗前升高,且观察组为(86.94±11.28)分,高于对照组的(80.53±9.15)分,差异有统计学意义(t=3.194,P<0.05)。结论肩关节镜术患者在进行手术治疗的过程中,选用超声引导下臂丛神经阻滞联合全身麻醉方式,可达到术中控制性降压的目的,提供满意的麻醉深度控制,同时有助于减轻术后疼痛感,提高患者肩关节运动功能。

Objective To analyze the effect of ultrasound-guided brachial plexus block anesthesia on clinical results and motor function in patients undergoing shoulder arthroscopy.Methods A total of 105 patients whom required shoulder arthroscopic surgery admitted to Wujin Hospital Affiliated to Jiangsu University from January 2020 to June 2023 were conveniently selected as the study objects.The patients were divided into the control group(52 cases,received general anesthesia)and the observation group(53 cases,received ultrasound-guided brachial plexus block combined with general anesthesia)according to the lottery method.The mean arterial pressure,heart rate,score of visual analogue scale(VAS)and score of alliance supplier evaluation standard(ASES)were compared between the two groups.Results The average arterial pressure and heart rate of the observation group were lower than those of the control group at T1(5 minutes after surgery),T2(30 minutes after surgery),and T3(30 minutes after tracheal intubation removal),and the differences were statistically significant(all P<0.05).The VAS scores of the observation group at postanesthesia care unit,6 hours after surgery,and 12 hours after surgery were lower than those of the control group,and the differences were statistically significant(all P<0.05).After treatment,the ASES scores of two groups increased compared to before treatment,and the observation group had(86.94±11.28)points,which was higher than the control group's(80.53±9.15)points,and the difference was statistically significant(t=3.194,P<0.05).Conclusion During the surgical treatment of patients undergoing shoulder arthroscopy,the ultrasound-guided brachial plexus block combined with general anesthesia can achieve the purpose of intraoperative controlled hypotension,provide satisfactory anesthesia depth control,help to reduce postoperative pain and improve the motor function of patients with shoulder joint.