全凭静脉麻醉复合臂丛神经阻滞对肩袖损伤患者术中血压、术野评分及术后VAS评分的影响  

Effect of total intravenous anesthesia combined with brachial plexus block on intraoperative blood pressure, surgical field score and postoperative VAS score in patients with rotator cuff injury

作　　者：胡佳艳[1] 袁佳[1] 李翃斌[1] HU Jiayan;YUAN Jia;LI Hongbin(Department of Anesthesiology,Zhoushan Hospital in Zhejiang Province,Zhoushan 316000,China)

机构地区：[1]浙江省舟山医院麻醉科

出　　处：《中国现代医生》2019年第25期120-123,共4页China Modern Doctor

基　　金：浙江省医药卫生一般研究计划(A类)项目(2016KYA182)

摘　　要：目的探讨全凭静脉麻醉复合臂丛神经阻滞对肩袖损伤患者术中血压、术野评分及术后VAS评分的影响。方法将2015年1月~2017年8月我院收治的86例肩袖损伤患者随机分为试验组与对照组,每组43例,对照组仅予以全凭静脉麻醉,试验组予以全凭静脉麻醉复合臂丛神经阻滞。记录并比较两组患者的MAP与HR、术野评分、术后镇痛药物使用情况、VAS评分。结果对照组拔管后(包括拔管时与拔管后5min)的MAP与HR明显高于麻醉前(P<0.05),试验组拔管后(包括拔管时与拔管后5min)的MAP与HR与麻醉前比较差异无统计学意义(P>0.05);试验组术中20min、40min及60min时的术野评分均低于对照组(P<0.05);试验组舒芬太尼用量[(0.38±0.11)μg/kg]显著低于对照组[(0.71±0.23)μg/kg],术后镇痛泵按压次数[(7.7±1.6)次]也明显少于对照组[(12.5±2.1)次],组间差异均有统计学意义(P<0.05);术后6h、12h、24h,试验组VAS评分均显著低于对照组,组间差异具有统计学意义(P<0.05)。结论全凭静脉麻醉复合臂丛神经阻滞可更好地维持术后血流动力学稳定,增加手术清晰度,有效缓解术后疼痛,减少镇痛药物用量。Objective To investigate the effect of total intravenous anesthesia combined with brachial plexus block on intraoperative blood pressure,surgical field score and postoperative VAS score in patients with rotator cuff injury.Methods A total of 86 patients with rotator cuff injury from January 2015 to August 2017 in our hospital were randomly divided into the experimental group and the control group,with 43 cases in each group.The control group was only given total intravenous anesthesia.The experimental group was treated with total intravenous anesthesia combined with brachial plexus block.MAP and HR,surgical field score,postoperative analgesic drug use,and VAS scores were recorded and compared between the two groups.Results The MAP and HR of the control group after extubation(including at extubation and 5 min after extubation)were significantly higher than those before anesthesia(P<0.05).The MAP and HR in the experimental group after extubation(including at extubation and 5 min after extubation)were not significantly different from those before anesthesia(P>0.05).The scores of the surgical field in the experimental group at intraoperative 20 min,40 min and 60 min were lower than those in the control group(P<0.05).The dose of sufentanyl in the experimental group was[(0.38±0.11)μg/kg],which was significantly lower than that of the control group[(0.71±0.23)μg/kg],and the number of postoperative analgesia pump presses[(7.7±1.6)times]was also significantly lower than that of the control group[(12.5±2.1)times],with statistically significant difference(P<0.05).The VAS scores of the experimental group were significantly lower than those of the control group at 6 h,12 h,and 24 h after operation.The difference between the two groups was statistically significant(P<0.05).Conclusion Total intravenous anesthesia combined with brachial plexus block can better maintain postoperative hemodynamic stability,increase surgical clarity,effectively relieve postoperative pain,and reduce the use of analgesic drugs.

关 键 词：全凭静脉麻醉 臂丛神经阻滞 肩袖损伤 术野评分 

分 类 号：R614[医药卫生—麻醉学]