超声引导下胸神经阻滞技术对肩胛骨骨折手术患者的镇痛效果  

Analgesic effect of ultrasonic-guided thoracic nerve block in patients with scapula fracture surgery

作　　者：刘庆辉 乔志[2] LIU Qing-hui;QIAO Zhi(Department of Anesthesiology,Zhengzhou the First People's Hospital,Zhengzhou 450000,China;不详)

机构地区：[1]郑州市第一人民医院麻醉科,郑州450000 [2]郑州大学第一附属医院骨科,郑州450052

出　　处：《医药论坛杂志》2021年第9期18-21,共4页Journal of Medical Forum

基　　金：2019年度河南省医学科技攻关计划项目(LHGJ20190169)。

摘　　要：目的分析超声引导下胸神经阻滞技术用于肩胛骨骨折手术中的镇痛作用。方法以2017年11月—2019年12月郑州市第一人民医院收治的79例肩胛骨骨折患者为对象,对应用气管插管全身麻醉处理的患者39例定为对照组,对超声引导下胸神经阻滞技术处理的40例气管插管全身麻醉患者定为观察组,比较两组麻醉效果。结果观察组切皮后5 min心率(HR)、平均动脉压(MAP)水平均低于对照组,差异有统计学意义(P<0.05);观察组术中舒芬太尼追加量(15.43±3.95)μg,少于对照组(38.42±5.51)μg,术后PACU停留时间(52.62±5.49)min,短于对照组(68.73±6.62)min,组间对比差异显著(P<0.05);观察组苏醒期躁动率、疼痛主诉率(5.00%、7.50%)均低于对照组(20.51%、28.21%)(P<0.05);观察组术后1、6、12、24 h疼痛VAS评分均低于对照组(P<0.05)。结论超声引导下胸神经阻滞技术用于肩胛骨骨折手术麻醉中可稳定患者术中体征水平,减少复苏期躁动及疼痛,术后疼痛程度更轻,值得推广应用。Objective To analyze the analgesic effect of ultrasonic-guided thoracic nerve block in the operation of scapula fracture.Methods A total of 79 patients with scapula fracture from November 2017 to December 2019 were divided into control group(39 cases)and observation group(40 cases)according to the random number table method.The control group received endotracheal intubation general anesthesia,and the observation group received ultrasound guided thoracic nerve block.The anesthesia effect of the two groups was compared.Results HR and MAP levels in the observation group were lower than those in the control group 5 minutes after peeling(P<0.05).The amount of sufentanil(15.43±3.95)g in the observation group was less than that in the control group(38.42±5.51)g,and the retention time of PACU(52.62±5.49)minutes after operation was shorter than that in the control group(68.73±6.62)minutes(P<0.05).The agitation rate and pain chief complaint rate(5.00%,7.50%)in the observation group were lower than those in the control group(20.51%,28.21%)(P<0.05).VAS scores at 1,6,12 and 24 hours after surgery in the observation group were all lower than those in the control group(P<0.05).Conclusion The application of ultrasonic-guided thoracic nerve block in anesthesia for scapula fracture can stabilize intraoperative signs,reduce restlessness and pain in the recovery period,and reduce postoperative pain to a less severe extent,which is worthy of popularization and application.

关 键 词：肩胛骨 骨折 手术 超声引导 胸神经阻滞技术 镇痛 

分 类 号：R614[医药卫生—麻醉学]