摘要
目的:探讨超声引导下锁骨下连续臂丛神经阻滞在尺桡骨骨折术后镇痛的临床效果。方法:选取2020年1月-2021年12月在江西省中西医结合医院行手术治疗的82例尺桡骨骨折患者,按照随机数字表法将患者分为研究组和对照组,各41例。两组均在锁骨下连续臂丛神经阻滞麻醉行切开复位内固定术,对照组在神经刺激仪引导下进行神经阻滞定位,研究组则在超声引导下进行神经阻滞定位。比较两组疼痛数字评分法(NRS)评分及尺动脉血流动力学指标[舒张末期速度(EDV)、收缩期峰速度(PSV)、血流量(Q)、搏动指数(PI)和阻力指数(RI)]。结果:术后8、24、48 h,研究组静止和主动运动时NRS评分均低于对照组,差异均有统计学意义(P<0.05)。阻滞后30 min,研究组EDV、Q均高于对照组,PI、RI均低于对照组,差异均有统计学意义(P<0.05);阻滞后30 min,两组PSV比较,差异无统计学意义(P>0.05)。结论:超声引导下锁骨下连续臂丛神经阻滞应用于尺桡骨骨折术后镇痛效果显著,对患者术后疼痛及尺动脉血流动力学指标均能有效改善,值得临床推广应用。
Objective:To investigate the clinical effect of ultrasound-guided subclavian continuous brachial plexus block in postoperative analgesia of ulnar and radius fractures.Method:A total of 82 patients with ulna and radius fractures who underwent surgical treatment in Jiangxi Hospital of Integrated Traditional Chinese and Western Medicine from January 2020 to December 2021 were selected,and they were divided into study group and control group according to random number table method,with 41 cases in each group.Both groups underwent open reduction and internal fixation under subclavian continuous brachial plexus block anesthesia.The control group received nerve block localization under the guidance of nerve stimulator,while the study group received nerve block localization under the guidance of ultrasound.Numerical rating scale(NRS)scores and ulnar arterial hemodynamics[end diastolic velocity(EDV),peak systolic velocity(PSV),blood flow(Q),pulsatile index(PI)and resistance index(RI)]were compared between two groups.Result:At 8,24,48 h after surgery,the NRS scores of the study group were lower than those of the control group at rest and active movement,the differences were statistically significant(P<0.05).30 min after block,EDV and Q of the study group were higher than those of the control group,while PI and RI of the study group were lower than those of the control group,the differences were statistically significant(P<0.05);there was no significant difference in PSV between the two groups at 30 min after block(P>0.05).Conclusion:Ultrasound-guided subclavian continuous brachial plexus block has a significant postoperative analgesic effect on ulnar and radius fractures,which can effectively improve postoperative pain and blood flow dynamics indexes of ulnar artery,which is worthy of clinical application.
作者
杨芳
邱莹
胡海涛
YANG Fang;QIU Ying;HU Haitao(Jiangxi Hospital of Integrated Traditional Chinese and Western Medicine,Nanchang 330003,China;不详)
出处
《中国医学创新》
CAS
2022年第20期113-117,共5页
Medical Innovation of China
基金
江西省卫生计生委科技计划项目(202211474)
江西省医学学科省市共建计划项目(赣卫科教字[2020]24号)。
关键词
超声
锁骨下连续臂丛神经阻滞
术后镇痛
Ultrasound
Subclavian continuous brachial plexus block
Postoperative analgesia
