臂丛神经阻滞复合全身麻醉在肩关节镜手术中的应用  

Brachial Plexus Block Combined with General Anesthesia in Arthroscopic Shoulder Surgery

作　　者：韩彬[1] 贾东林[1] 于琳琳[1] 王军[1] 

机构地区：[1]北京大学第三医院麻醉科,北京100191

出　　处：《中国微创外科杂志》2011年第12期1108-1110,共3页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨臂丛神经阻滞复合全身麻醉在肩关节镜手术中的应用价值。方法 60例ASAⅠ～Ⅱ级肩关节镜手术患者,按病例单双号分为2组:联合组采用超声引导下臂丛神经阻滞复合全身麻醉,全麻组单纯采用全身麻醉。记录术前、手术开始5 min、手术结束时和拔除气管导管后10 min患者的血压、心率,并记录手术时间、手术结束至拔除气管导管时间(拔管时间)、阿片类镇痛药物用量、患者总体满意度、联合组臂丛阻滞并发症等指标。结果与全麻组相比,联合组拔管时间更短[(7.5±4.1)min vs.(10.0±5.1)min,t=-2.085,P=0.042],镇痛药物(瑞芬太尼)用量更少[(282.7±110.4)mgvs.(516.7±193.1)mg,t=-5.685,P=0.000)],而且联合组患者的满意度较高[(8.1±0.7)分vs.(6.8±0.6)分,t=7.447,P=0.000)]。结论全身麻醉复合肌间沟臂丛神经阻滞用于肩关节镜手术,能够提供平稳的麻醉状态,减少阿片类镇痛药的用量,提高患者满意度。Objective To investigate the value of brachial plexus block combined with general anesthesia in arthroscopic shoulder surgery. Methods Totally 60 American Society of Anesthesiology （ASA） physical status Ⅰ - Ⅱ patients undergoing selective arthroscopic shoulder surgery were allocated into two groups： group I recieved ultrasound-guided intersealene brachial plexus block before general anesthesia, and group Ⅱ underwent general anesthesia only. The arterial blood pressure and heart rate before the surgery, 5 min after the beginning of the surgery, at the end of the surgery, and after removing the tracheal catheter were recorded. The operation time, cxtubation time, dosage of opioids used, patients＇ overall satisfaction and adverse effects of brachial plexus block were also analyzed. Results Compared with group Ⅱ , patients in group I had significantly shorter extubation time [ （7.5 ± 4.1 ） min, vs. （10.0 ±5. 1） min, t = -2.085,P =0.042], lower opioid dosage [（282.7 ± 110.4） mg vs. （516.7 ± 193. 1） mg, t = -5.685,P=0.000] , and better overall satisfaction score （8. 1 ±0.7 vs. 6. 8 ± 0.6, t = 7. 447, P =0. 000） . Conclusion Ultrasound-guided braehial plexus block combined with general anesthesia provides good anesthesia status, reduces opioid usage and increases patients＇ overall satisfaction.

关 键 词：肩关节镜手术 超声 臂丛阻滞 

分 类 号：R614.2[医药卫生—麻醉学]