本文選題：頸神經(jīng)根阻滯 + 肌間溝臂叢阻滯�。� 參考：《臨床麻醉學(xué)雜志》2017年12期

【摘要】：目的比較超聲引導(dǎo)下選擇性頸神經(jīng)根阻滯與傳統(tǒng)肌間溝臂叢阻滯在肩關(guān)節(jié)鏡術(shù)后鎮(zhèn)痛的應(yīng)用效果。方法擇期行肩關(guān)節(jié)鏡手術(shù)全麻患者70例,男25例,女45例,年齡18~75歲,隨機(jī)分為兩組,選擇性頸神經(jīng)根阻滯組(S組)和傳統(tǒng)肌間溝臂叢阻滯組(ISB組),每組35例。S組在超聲引導(dǎo)下分別給予C5、C6神經(jīng)根0.5%羅哌卡因各5ml;ISB組在超聲引導(dǎo)下給予0.5%羅哌卡因10ml。記錄神經(jīng)阻滯起效時(shí)間;記錄術(shù)后4、12、24h的VAS評(píng)分和前臂(屈肘、屈腕、屈指)MBS運(yùn)動(dòng)評(píng)分;記錄術(shù)后24h曲馬多用量,以及患者滿(mǎn)意度和不良反應(yīng)發(fā)生情況。結(jié)果 S組起效時(shí)間明顯短于ISB組[(8.24±2.96)min vs(13.85±7.45)min,P0.01];S組術(shù)后12h的VAS評(píng)分明顯低于ISB組[(1.7±0.8)分vs(3.6±0.7)分,P0.05],術(shù)后4h前臂(屈肘、屈腕、屈指)MBS運(yùn)動(dòng)評(píng)分明顯高于ISB組[(3.5±0.6)分vs(0.8±0.3)分,(3.4±0.5)分vs(0.9±0.4)分,(3.6±0.6)分vs(0.7±0.4)分,P0.01];術(shù)后24h曲馬多用量明顯少于ISB組[(37.5±35.9)mg vs(112.5±43.5)mg,P0.05],患者滿(mǎn)意率明顯高于ISB組(88%vs 56%,P0.05),術(shù)后不良反應(yīng)兩組差異無(wú)統(tǒng)計(jì)學(xué)意義。結(jié)論在肩關(guān)節(jié)鏡手術(shù)后鎮(zhèn)痛中,超聲引導(dǎo)下選擇性頸神經(jīng)根阻滯優(yōu)于臂叢神經(jīng)阻滯。
[Abstract]:Objective to compare the effect of selective cervical nerve root block and traditional intermuscular sulcus brachial plexus block under ultrasonic guidance in postoperative analgesia. Methods 70 patients (25 males and 45 females, aged 1875 years) undergoing selective shoulder arthroscopic anesthesia were randomly divided into two groups. The selective cervical nerve root block group (group S) and the traditional intermuscular sulcus brachial plexus block group (group ISB) were treated with 0.5% ropivacaine (0.5% ropivacaine) and 10 ml ropivacaine (10 ml) under ultrasound guidance respectively. The onset time of nerve block, the score of VAS and the motor score of forearm (elbow, wrist and finger flexion), the dosage of tramadol, the satisfaction of patients and the occurrence of adverse reactions were recorded. Results the effective time of S group was significantly shorter than that of ISB group [8.24 鹵2.96)min vs(13.85 鹵7.45 min P0.01] the VAS score of S group was significantly lower than that of ISB group (1.7 鹵0.8 vs(3.6 鹵0.7) at 12 hours after operation, and the forearm (elbow flexion, wrist flexion) 4 hours after operation was significantly lower than that in ISB group. The motor score of flexion was significantly higher than that of ISB group (3.5 鹵0.6 vs(0.8 鹵0.3) vs(0.9 鹵0.4), and the dosage of tramadol at 24 hours after operation was significantly lower than that in ISB group [37.5 鹵35.9)mg vs(112.5 鹵43.5mgP0.05], the satisfaction rate was significantly higher than that in ISB group (88 鹵0.50 vs 5656 vs 0.05), and there was no significant difference in postoperative adverse reactions between the two groups. Conclusion selective cervical nerve root block under ultrasonic guidance is superior to brachial plexus block in postoperative analgesia.
【作者單位】： 南京中醫(yī)藥大學(xué)附屬醫(yī)院麻醉科;
【分類(lèi)號(hào)】：R614

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