超声引导不同入路的臂丛神经阻滞复合全身麻醉在肩关节镜手术的效果应用分析  

Effect of Ultrasound Guided Brachial Plexus Nerve Block Combined with General Anesthesia in Shoulder Arthroscopic Surgery

作　　者：刘宇权 曾志文[1] 廖亿粦[1] 罗荣 朱海坤 Liu Yuquan;Zeng Zhiwen;Liao Yilin;Luo Rong;Zhu Haikun(First Department of Anesthesiology,Meizhou People's Hospital,Meizhou 514031)

机构地区：[1]梅州市人民医院麻醉一科,梅州514031

出　　处：《数理医药学杂志》2020年第6期800-802,共3页Journal of Mathematical Medicine

摘　　要：目的:评价超声引导不同入路的臂丛神经阻滞复合全身麻醉在肩关节镜手术的应用效果。方法:选择2018年1月~2019年10月来某院就诊行肩关节镜手术治疗的患者为主要研究目标,选出54例。以密封信封不透光法为分组原则分为对照组和观察组各27例,均在超声引导下实施麻醉,对照组接受锁骨上入路臂丛神经阻滞复合全麻,观察组采取腋入路臂丛神经阻滞复合全身麻醉,对比麻醉前后患者的血压、心率变化和临床各项指标。结果:麻醉前两组患者的血压、心率值对比无统计学意义,麻醉后观察组患者的血压、心率变化幅度小于对照组,组间对比有统计差异(P<0.05);观察组患者的手术时间、苏醒时间、麻醉起效时间比对照组短,疼痛评分低于对照组,差异有统计学意义(P<0.05);观察组麻醉后产生的不良反应显著少于对照组,差异有统计学意义(P<0.05)。结论:肩关节镜手术治疗中选择超声引导下腋入路臂丛神经阻滞复合全身麻醉的麻醉效果更可靠、安全,对患者生命体征影响小,值得临床借鉴。Objective:To evaluate the effect of ultrasound-guided brachial plexus block combined with general anesthesia in shoulder arthroscopic surgery. Methods:54 patients who came to a hospital from January 2018 to October 2019 for arthroscopic shoulder surgery were selected as the main research objectives. 27 cases in the control group and 27 cases in the observation group were anesthetized under the guidance of ultrasound. The control group received brachial plexus block combined with general anesthesia via supraclavicular approach. The observation group received brachial plexus block combined with general anesthesia via axillary approach. The changes of blood pressure, heart rate and clinical indicators of patients before and after anesthesia were compared. Results: There was no statistical significance in the comparison of blood pressure and heart rate between the two groups before anesthesia. After anesthesia, the change range of blood pressure and heart rate in the observation group was smaller than that in the control group, and there was statistical difference between the two groups(P<0.05). The operation time, recovery time and anesthesia onset time in the observation group were shorter than those in the control group, and the pain score was lower than that in the control group, and the difference was statistically significant(P<0.05). The adverse reactions in the observation group were significantly less than those in the control group(P<0.05). Conclusion:In the treatment of shoulder arthroscopy, the anesthesia effect of brachial plexus block combined with general anesthesia via axillary approach guided by ultrasound is more reliable and safe, and has little effect on vital signs of patients, which is worth clinical reference.

关 键 词：超声引导 不同入路 臂丛神经阻滞 全身麻醉 肩关节镜手术 

分 类 号：R614.4[医药卫生—麻醉学]