摘要
目的:探讨超声引导下肩胛背神经阻滞在肩关节镜手术后疼痛治疗中的应用效果。方法:选取医院收治的60例接受肩关节镜手术的患者,根据术后疼痛治疗方法的不同将其分为肩胛背神经阻滞组、肌间沟臂丛神经阻滞组和口服药镇痛治疗组,每组20例。比较3组患者的疼痛视觉模拟量表(VAS)评分、术后24 h内镇痛泵有效按压次数及哌替啶补救镇痛例数、离开麻醉恢复室时与术后6 h患侧肢体麻木程度、麻醉复苏后不良反应及患者满意度。结果:3组患者术后拔管即刻、术后3 h、6 h、12 h及24 h的静息状态及活动状态下VAS评分,差异均无统计学意义(t术后拔管即刻=1.04,t=1.11;t术后3 h=0.97,t=1.03;t术后6 h=0.86,t=0.93;t术后12 h=1.01,t=0.81;t术后24 h=1.17,t=1.01;P>0.05)。术后24 h内,肩胛背神经阻滞组镇痛泵有效按压次数和补救镇痛率差异无统计学意义(χ^(2)=1.347,χ^(2)=1.556;P>0.05)。肩胛背神经阻滞组离开麻醉恢复室时及术后6 h的患侧肢体麻木程度优于肌间沟臂丛神经阻滞组与口服药镇痛治疗组,差异具有统计学意义(χ^(2)=5.316,χ^(2)=5.452;P<0.05)。肩胛背神经阻滞组术后1 d上肢麻木无力与呼吸困难率均低于肌间沟臂丛神经阻滞组与口服药镇痛治疗组,差异具有统计学意义(χ^(2)=7.631,χ^(2)=6.973;P<0.05)。肩胛背神经阻滞组患者对术后镇痛效果满意率均高于肌间沟臂丛神经阻滞组与口服药镇痛治疗组,差异具有统计学意义(χ^(2)=6.592,χ^(2)=6.638;P<0.05)。结论:超声引导下肩胛背神经阻滞在术后具有良好的镇痛效果,可改善患侧肢体麻木程度及麻醉复苏后的不良反应,是安全有效的疼痛治疗方法。
Objective:To explore the application efficacy of ultrasound-guided dorsal scapular nerve block in treating postoperative pain after shoulder arthroscopic surgery.Methods:A total of 60 patients underwent shoulder arthroscopic surgery who admitted to hospital were selected,and all patients were divided into dorsal scapular nerve block group,intermuscular groove brachial plexus block group and oral analgesic therapy group according to the treatment methods for postoperative pain,with 20 cases in each group.The visual analogue score(VAS)of pain,the number of effective compressing analgesic pump within 24 hours after surgery and the number of cases of using pethidine to remedy analgesia,the degree of numbness in the affected limb at the time of leaving the anesthesia recovery room and 6 hours after surgery,adverse reactions after anesthesia resuscitation,and satisfaction of patient were compared among the three groups.Results:The differences of VAS scores of three groups at the time of extubation,the 3rd h,6th h,12th h and 24th h after surgery between resting state and action state were not significant(tat the time of extubation=1.04,t=1.11,t3rd h=0.97,t=1.03,t6th h=0.86,t=0.93,t12th h=1.01,t=0.81,t24th h=1.17,t=1.01,P>0.05),respectively.Within postoperative 24h,there were not significant differences between the number of effective compressing analgesic pump and the rate of remedy analgesia in dorsal scapular nerve block group(χ^(2)=1.347,χ^(2)=1.556,P>0.05),respectively.The degree of numbness in the affected limb at the time of leaving the anesthesia recovery room and the 6th hours after surgery in dorsal scapular nerve block group was significantly better than that in intermuscular groove brachial plexus block group and oral analgesic therapy group(χ^(2)=5.316,χ^(2)=5.452,P<0.05),respectively.The rate of upper limb numbness and weakness and the rate of difficulty breathing at 1st d after surgery in dorsal scapular nerve block group was significantly better than that in intermuscular groove brachial plexus block
作者
彭雪蕾
姜雨婷
刘雁
陈肖
PENG Xue-lei;JIANG Yu-ting;LIU Yan(Wuxi Medical College,Jiangnan University,Wuxi 214122,China;不详)
出处
《中国医学装备》
2023年第12期105-110,共6页
China Medical Equipment
基金
江苏省卫生健康委员会科研项目(20210334)“超声联合神经阴滞技术在顽固性背痛治疗中的效果研究”。
关键词
超声引导
肩胛背神经阻滞
疼痛治疗
术后镇痛
Ultrasound guidance
Dorsal scapular nerve block
Treatment for pain
Postoperative analgesia
