摘要
目的:探讨B超引导下肌间沟臂丛神经阻滞复合全凭静脉麻醉在肩关节镜手术中的应用效果。方法:选取2017年5月-2019年5月本院行肩关节镜手术患者68例。按照随机数字表法将其分为观察组和对照组,各34例。观察组给予B超引导下肌间沟臂丛神经阻滞复合全凭静脉麻醉,对照组给予单纯全凭静脉麻醉,比较两组不同时间点血压(SBP、DBP)、心率(HR)、血糖、皮质醇水平及临床指标。结果:两组不同时间点SBP、DBP水平比较,差异均无统计学意义(P>0.05);两组入室时(T0)HR水平比较,差异无统计学意义(P>0.05),观察组切皮时刻(T1)、手术开始30 min(T2)、手术开始60 min(T3)、拔管后10 min(T4)的HR水平均低于对照组,差异均有统计学意义(P<0.05)。两组T0、T1时血糖水平比较,差异均无统计学意义(P>0.05),观察组T2、T3、T4时血糖水平低于对照组,差异均有统计学意义(P<0.05);两组T0时皮质醇水平比较,差异无统计学意义(P>0.05),观察组T1、T2、T3、T4时皮质醇水平均低于对照组,差异均有统计学意义(P<0.05)。两组手术时间比较,差异无统计学意义(P>0.05),观察组术野质量评分、硝酸甘油使用率均低于对照组,瑞芬太尼用量、丙泊酚用量均少于对照组,差异均有统计学意义(P<0.05)。结论:B超引导下肌间沟臂丛神经阻滞复合全凭静脉麻醉应用于肩关节镜手术可有效辅助控制性降压,还能够降低术中应激反应,提高术野质量,减少全麻用药,降低麻醉风险,值得在临床上推广。
Objective:To investigate the effect of B-ultrasound guided intermuscular groove brachial plexus block combined with total intravenous anesthesia on shoulder arthroscopy.Method:From May 2017 to May 2019,68 patients underwent shoulder arthroscopy surgery in our hospital were selected.According to the method of random number table,they were divided into observation group and control group,34 cases in each group.The observation group was given intermuscular groove brachial plexus block combined with total intravenous anesthesia under the guidance of B-ultrasound,while the control group was given only total intravenous anesthesia.Blood pressure(SBP,DBP),heart rate(HR),blood glucose,cortisol at different time points and clinical indexes were compared in the two groups.Result:There were no significant differences in SBP and DBP between the two groups at different time points(P>0.05),there was no significant difference in HR level in the two groups when entering the room(T0)(P>0.05),the HR level in the the observation group were lower than those of the control group at peeling moment(T1),30 min after operation(T2),60 min after operation(T3),10 min after extubation(T4),the differences were statistically significant(P<0.05).There were no significant differences in blood glucose level between the two groups at T0 and T1(P>0.05),the blood glucose level at T2,T3 and T4 in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).There was no significant difference in cortisol level between the two groups at T0(P>0.05),the cortisol levels at T1,T2,T3 and T4 in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).There was no significant difference in operation time between the two groups(P>0.05),the quality score of operation field and the usage rate of nitroglycerin in the observation group were lower than those in the control group,the dosage of Remifentanil,Propofol were lower than those of the co
作者
杨秀菊
翁伟君
YANG Xiuju;WENG Weijun(The Third People’s Hospital of Huizhou City,Huizhou 516002,China)
出处
《中国医学创新》
CAS
2019年第36期19-23,共5页
Medical Innovation of China
基金
惠州市科技计划项目（180522091746206）
关键词
超声
肌间沟臂丛神经阻滞
静脉麻醉
肩关节镜
Ultrasound
Intermuscular groove brachial plexus block
Intravenous anesthesia
Shoulder arthroscopy
