摘要
目的:观察在神经刺激定位仪引导下肩胛上神经阻滞联合镇痛对关节镜下肩袖修复术后早期的镇痛效果。方法:将43例关节镜下行肩袖损伤修复术的患者随机分为治疗组(20例)与对照组(23例),治疗组采用术前神经刺激定位仪引导下肩胛上神经阻滞+术后静脉自控镇痛泵,对照组手术后仅选取静脉自控镇痛泵进行医治。全部病患分别于手术后6、12、24和48 h记录静息状态下的VAS疼痛评分和术后12、24和48 h运动状态下的VAS疼痛评分,同时记录术后选择性镇痛药物吗啡的用量及其不良反应的发生率。结果:治疗组患者术后6、12 h静息状态下VAS评分低于对照组,差异有统计学意义(P<0.05);术后24、48 h静息状态下VAS评分与对照组比较,差异无统计学意义(P>0.05)。治疗组术后12、24和48 h运动状态下VAS评分明显低于对照组,差异有统计学意义(P<0.05);治疗组术后吗啡的使用量及不良反应的发生率明显低于对照组,差异有统计学意义(P<0.05)。结论:肩胛上神经阻滞联合镇痛对于关节镜下肩袖修复术围手术期的镇痛疗效明显优于单纯静脉自控镇痛泵,可有效减轻术后疼痛并促进关节功能早期恢复,降低患者术后选择性镇痛药物的使用量及药物相关不良反应的发生率。
Objective： To evaluate the analgesic effect of suprascapular nerve block under nerve stimulator combined with analgesia for shoulder rotator cuff repair under arthroscopy in early postoperative period. Methods： In the present prospective, randomized clinical study, 43 patients who received shoulder rotator cuff repair under arthroscopy were divided into two groups： 20 patients（treatment group） were treated with preoperative nerve stimulation locator-guided suprascapular nerve block ＋ postoperative patient controlled intravenous analgesia and 23 patients（control group） only used patient controlled intravenous analgesia after the surgery. The pain levels were measured using visual analog scale（VAS） at 6, 12, 24, and 48 h after surgery at resting state and 12, 24, 48 h after surgery at motion state. At the same time, the amount of morphine and the incidence of adverse reactions were recorded. Results： The postoperative resting state VAS scores at 6, 12 h of the treatment group were lower than the control group（P〈0.05）. The postoperative resting state VAS scores at 24, 48 h had no statistically significant difference（P〉0.05）. The motion state VAS scores at 12, 24, 48 h of the treatment group were significantly lower than the control group（P〈0.05）. The postoperative morphine consumption and the incidence of adverse reactions of the treatment group were obviously lower than the control group（P〈0.05）. Conclusion： The analgesic effect of combined analgesia with suprascapular nerve block is superior to that of single patient controlled intravenous analgesia, and it can also promote the early recovery of joint function and reduce the consumption of postoperative selective analgesic drugs and incidence of drug related adverse reactions.
出处
《临床药物治疗杂志》
2017年第7期68-71,共4页
Clinical Medication Journal
基金
新疆医科大学科研创新基金项目(XJC201379)
关键词
肩关节镜
肩胛上神经阻滞
围手术期
疼痛管理
shoulder arthroscopy
suprascapular nerve block
perioperative period
pain management
