超声引导下臂丛神经阻滞对肩关节镜手术患者术后快速康复的影响  

Impacts of ultrasound-guided brachial plexus block on fast track rehabilitation after shoulder arthroscopy

作　　者：黄志强 张伟强[1] 罗荣[1] 曾志文[1] UANG Zhiqiang;ZHANG Weiqiang;LUO Rong;ZENG Zhiwen(The 1st Department of Anesthesiology,Meizhou People's Hospital in Guangdong Province,Meizhou 514000,China)

机构地区：[1]广东省梅州市人民医院麻醉一科,广东梅州514000

出　　处：《中国现代医生》2020年第8期133-136,共4页China Modern Doctor

摘　　要：目的探讨超声引导下臂丛神经阻滞对肩关节镜手术患者术后快速康复的影响。方法选取2017年6月~2019年9月在我院骨科改关节外科行肩关节镜手术的60例患者,随机分为两组,对照组单用全身麻醉,在此基础上观察组行超声引导下臂丛神经阻滞,对比两组的术中血流动力学变化、术后疼痛情况、术后不同时间上肢功能。结果观察组在手术开始5 min(T1)、手术开始30 min(T2)、手术结束时(T3)、拔除气管导管30 min时(T4)的HR和MAP均低于对照组(P<0.05);观察组苏醒即刻、术后6 h、术后12 h、术后24 h的VAS疼痛评分均低于对照组(P<0.05);观察组术后6 h、12 h、24 h的上肢功能评分明显高于对照组(P<0.05)。结论超声引导下臂丛神经阻滞在肩关节镜手术的麻醉效果良好,能有效稳定术中血流动力学,减轻术后疼痛,加快上肢功能的恢复锻炼,具有积极的临床意义。Objective To investigate impacts of ultrasound-guided brachial plexus block on fast track rehabilitation after shoulder arthroscopy.Methods Sixty patients transferred from the Department of Orthopedics at our hospital to the Department of Joint Surgery for shoulder arthroscopy from June 2017 to September 2019 were randomly divided into two groups.Patients in the control group underwent general anesthesia,whilethose in the observation group additionally received ultrasound-guided brachial plexus block.Haemodynamics,postoperative pain and upper limb function at different time points after shoulder arthroscopy were compared between the two groups.Results Heart rate(HR)and mean arterial blood pressure(MAP)in the observation group were significantly lower than the control group at 5 min(T1)and30 min after the beginning of surgery(T2),at the end of surgery(T3)and at 30 min after extubation(T4)(P<0.05).Visual analogue scale(VAS)scores at anesthesia recovery time and 6 h,12 h and 24 h after surgery in the observation group were significantly lower than the control group(P<0.05).Scores of upper-limb function assessment at 6 h,12 h and 24 h after surgery in the observation group were significantly higher than the control group(P<0.05).Conclusion Ultrasoundguided brachial plexus block during general anesthesia in shoulder arthroscopy showed favorable anesthetic effects.It stably maintained intraoperative haemodynamics,reduced postoperative pain and promoted recovery of upper limb function,presenting significant clinical value.

关 键 词：肩关节镜手术 超声引导下臂丛神经阻滞 术后快速康复 上肢功能 

分 类 号：R614[医药卫生—麻醉学]