超声引导无阻力法定位与神经刺激器引导定位连续颈椎旁阻滞用于术后镇痛的效果比较  

Comparison of ultrasound guided combined with no resistance technology and stimulator guided for continuous cervical paravertebral block for postoperative pain control after shoulder surgery

作　　者：胡焱[1] 蔡楠[1] 刘雪冰[1] 朱丰[1] 张伟[1] 

机构地区：[1]北京积水潭医院麻醉科,北京100035

出　　处：《中国医刊》2017年第6期74-77,共4页Chinese Journal of Medicine

摘　　要：目的比较超声引导无阻力法定位与神经刺激引导定位连续颈椎旁阻滞在肩关节手术后镇痛中的效果。方法将2015年2月至2016年3月在本院拟行肩关节镜手术的40例患者随机分为超声引导无阻力法定位连续颈椎旁阻滞组(N组)和神经刺激器引导定位连续颈椎旁阻滞组(S组),每组20例,比较两组的操作时间,离开恢复室及术后4、24、48小时时间点静息和运动(肩关节外展45°)时的视觉模拟评分(VAS),术后4、24、48小时时间点的前臂肌力,术后不良反应及辅助镇痛药用量等指标。结果 S组的操作时间明显高于N组(P<0.01),试探穿刺次数明显多于N组(P<0.01)。两组患者术后各时间点VAS评分及前臂肌力差异无显著性(P>0.05)。两组术后均无严重不良反应发生。结论与神经刺激引导定位法相比,超声引导无阻力定位连续颈椎旁阻滞能够明显缩短操作时间,而术后镇痛效果及并发症发生情况明显差异。Objective To compare the methods of stimulator guided or ultrasound guided combined with no resistance used for continuous cervical paravertebral block （CCPV） for postoperative pain control of shoulder surgery. Method Forty patients scheduled for shoulder surgery in our hospital between February 2015 and march 2016 were randomly assigned to two groups： Group S or Group N. In Group S, blocks were performed guided by stimulator. In Group N, blocks were performed guided by ultrasound combined with no resistance technology. By the time patients left post anesthesia recovery room and on postoperative 4h, 24h, 48h, the VAS pain scores during rest and movement were noted. The muscle strength of forearm, side effects, complementary pain killers were also noted on the above time points. Result The perform duration time in Group S was significantly longer than in Group N （P〈0.01）. There was no statistical significant differences between the two groups on all time points considering VAS pain scores, muscle strength and side effects （P〉0.05）. Conclusion Ultrasound guided combined with no resistance technology can improve efficiency and shorten the block performance time and have the same pain control effect and similar side effects.

关 键 词：超声引导 神经刺激器引导 颈椎旁阻滞 肩关节手术 术后镇痛 

分 类 号：R614.42[医药卫生—麻醉学]